COVID-19 Notification Form

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This form is to be completed by parents if, for any reason, your child needs to isolate. Please provide as much detailed information as possible.

Once you receive your results please call the school office on 01606 288110 or email them on office@wharton.cheshire.sch.uk

Email *

Child's Name(s) *

Child's Class(es) *

Parent Name *

Name of the person with symptoms *

Relationship of this person to your child(ren)

Date of onset of symptoms *

YYYY

Date of COVID-19 test *

YYYY

What are the symptoms of the affected person? *

Loss/Change of taste

Loss/Change of smell

Persistent cough

Raised temperature

Other:

Required

My child is currently: *

Home Learning

Attending School

Any other relevant information

Send me a copy of my responses.

Submit

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