JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Wantagh UFSD COVID-19 Student Reporting Form
Please use this form if your child receives a positive COVID-19 diagnosis and report it to your child's school nurse as well.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
School Child Attends
*
Forest Lake Elementary School
Wantagh Elementary School
Mandalay Elementary School
Wantagh Middle School
Wantagh High School
Child's Grade
*
K
1
2
3
4
5
6
7
8
9
10
11
12
Please select your reason for using this form.
My child tested positive for COVID-19.
My child is a close contact of someone that tested positive for COVID-19.
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wantagh UFSD.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
