JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Covid Results Submission
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Date of Test
*
MM
/
DD
/
YYYY
Hour of Test
*
Your answer
Is this test part of daily contact testing?
*
No
Yes
First Name (of the person being tested). Please do not enter middle names.
*
Please just put the first name and check there are no trailing spaces. e,g, "Taylor"
Your answer
Last Name (of the person being tested)
*
Your answer
Year Group
*
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Year 13
Year 14
Result
*
Positive
Negative
Void
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Poole High School.
Report Abuse
Forms
