Report a COVID-19 Case
Parents of PK-12 students, please complete this form and also contact your child's coach or sponsor if they are in 7-12 grade extra-curricular activities.
Email address *
Name & phone number of person making this report *
Student's Last Name *
Student's First Name *
Building Student Attends *
Grade Level & Teacher if PK-5 student *
Student *
Date of Test or Exposure
Student has the following symptoms *
Date of Return provided by Doctor or Public Health
Names & grades of other children in the home that attend KCSD schools.
Please share any other information that would be helpful or questions.
Would you like a call from KCSD Nurse, Angie Mitchell after the holidays? *
Never submit passwords through Google Forms.
This form was created inside of Knoxville Schools. Report Abuse