COVID 19 Monitoring
Please complete the information below if your student is showing symptoms or has been in contact with an individual who has tested positive for COVID-19.
अपनी प्रगति को सेव करने के लिए Google में साइन इन करें. ज़्यादा जानें
Student Name *
Grade Level *
Parent/Guardian Name *
Phone Number *
My child is showing the following symptoms *
If you chose fever, please list the temperature your child has. Put none if your child does not have a fever. *
My child has been in contact with an individual who has tested positive. *
My child has been seen by a medical professional *
Please use the space below for additional comments or explanations.
सबमिट करें
फ़ॉर्म में भरी गई जानकारी मिटाएं
कभी भी Google फ़ॉर्म के ज़रिए पासवर्ड सबमिट न करें.
यह फ़ॉर्म Crane R-III School District के अंदर बनाया गया था. बुरे बर्ताव की शिकायत करें
Google फ़ॉर्म