Positive COVID-19 Test  or Confirmed Exposure
Please fill out this form to alert Regina Catholic Education Center that your student has either tested positive for COVID-19 or has had a confirmed exposure to someone else who has tested positive.
The information that you provide will only be used by school personnel to help us to do contact tracing and help to protect other children and staff in our school community.  
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Email *
Family & Student Information
Please provide the names and communication contact methods for the parent/guardian and student.
Parent/Guardian Name *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Student First Name *
Student Last Name *
Student Grade Level *
Exposure/Testing Information
Please provide answers to the following questions regarding COVID-19 exposure and testing.
Date the student last attended school, childcare and any athletic practice or clubs at Regina *
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Date that student first developed symptoms
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Symptoms that student has experienced *
Required
Please let us know if your child has tested positive for COVID-19 or has been directly exposed to someone else that has tested positive. *
Date of positive COVID-19 test or confirmed direct exposure to someone else who has tested positive. *
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Comments regarding exposure - Please provide some basic information regarding the student's exposure.
Do you need information regarding COVID-19 testing and resources? *
Please list your student's homeroom teacher name here if in PK - 6th grade.
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