COVID-19 Weekly Testing - Part A

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COVID-19 Weekly Testing - Part A - CAGS

Last Name: *

First Name: *

Have you received a positive COVID-19 PCR in the past 90 days? If you answer yes, you will have to upload your positive results in Part B. *

No, I did not.

Yes, I did.

If you had a COVID-19 positive PCR test within the last 90 days, what day did you receive your positive test? If you did not receive a positive PCR test within the last 90 days, write n/a. *

Position in District: *

Teacher

Paraprofessional

Child Study Team Member (CST)

Aramark Employee

Sodexo Employee

Secretary

Nurse

Guidance Counselor

Speech Therapist

Occupational Therapist

Physical Therapist

Security Specialist

Other

I took my weekly COVID-19 PCR test on:

YYYY

I took my weekly COVID-19 PCR at: *

School/District through Chemed Health

Other

I understand that if I am not vaccinated, I must have weekly testing done and submit my weekly results via Part B. If I do not, I will not be permitted to work, and will have my pay docked. If I am absent on the day of District COVID-19 testing, I am responsible for getting my own COVID PCR test. *

I understand.

I do not understand.

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