Positive Covid Test Notification
LFT or PCR.
Sign in to Google to save your progress. Learn more
Please provide all name/s of child/family member/s (or member of family bubble) who has/have tested positive for Covid 19:
Relationship to child/ren  (if not the child).
Name/s and class/es of children affected:
Date of positive test:
MM
/
DD
/
YYYY
Date of onset of symptoms:
MM
/
DD
/
YYYY
Contact phone number. *
It is your responsibility to identify any close contacts and/or work with test and trace.  
A close contact is defined as anyone who has been closer than 1m for more than one minute and more than 1m but less than 2m to the positive case for more than 15 minutes.
Should you have any queries or wish to speak to a staff member, please contact: 07715651982
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Burley Oaks. Report Abuse
Google Forms