Attestation form
Per AUSD Health and Safety guidelines this form is for Parents and/or Legal Guardian to attest that their student has adhered to the PCOE and AUSD guidelines for asymptomatic close contact exposure. This information will be used to allow students to remain in In-person instruction.
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Student Name: *
School Location *
Date of Close Contact Exposure *
MM
/
DD
/
YYYY
Has your student remained asymptomatic?
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Has your student continued to follow mask mandate requirements? *
Did your student test for COVID 3-5 day from date of last exposure? *
Did your student received negative COVID-19 testing results? *
What type of test did your student use?
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Parent/Guardian Electronic Signature: *
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