Reporting a student who has COVID-19
Please complete and submit this form for each student who has received a positive lab result for COVID-19. This information will remain confidential, and will assist our school nursing staff in determining if other students or adults may have been exposed. You may be contacted by a registered nurse from the School District.

Even if the student was not present in school before they showed symptoms or began an isolation period at home, please let us know if they have tested positive so that our health and attendance records are complete.
Email address *
School *
What school does your child attend?
Student *
First and last name of student
Date of Birth *
Student's date of birth
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DD
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YYYY
Grade *
Student's grade level
Parent *
Parent's first and last name or person submitting this form
Phone Number *
Phone number of parent or person submitting this form
Date student was tested *
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/
DD
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YYYY
Household Members *
Are any other household members part of the Coeur d'Alene School District?
Notes
Is there anything else you believe we should know, including the names of any siblings or household members, if part of the Coeur d'Alene School District?
A copy of your responses will be emailed to the address you provided.
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