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COVID Reporting Form
Please use this form to report positive test results or symptoms of COVID-19.
⚠️ Family collaboration opportunity: You will need information about your student in order to complete it!
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* Indicates required question
Grade
*
What grade is your student currently In?
6
7
8
Name
*
My child's first and last name is...
Your answer
Student ID
*
My child's lunch number / student ID # is...
Your answer
Status
*
At this time, my child... (check all that apply)
Has tested positive for COVID-19
Is experiencing symptoms of COVID-19
Has been in close contact with someone who tested positive for COVID-19
Required
Covid vaccine status
*
My child's vaccination status is...
Unvaccinated
One dose of Pfizer or Moderna vaccine
One dose of Johnson & Johnson vaccine
Fully vaccinated with two doses of Pfizer or Moderna vaccine
My child is fully vaccinated and has received a booster
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