SCPS Positive Reporting Form
Please complete the following form if your student has tested positive. ONLY FILL OUT ONE FORM PER CHILD and be sure to choose the correct school.  When you have completed the form, you should receive a confirmation that the form was submitted, if you did not, the form did not go through. Your student will need to email their teachers to make them aware of their absence so any school work can be provided virtually. If you need a laptop to complete virtual work (hot-spots will not be available), please contact the school and let them know. If you do not have an email address, you may provide your students school email address.
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Email *
School Student Attends/Nurse Email *
Please select the email address for your school nurse. If you are unsure, please refer to the previous question. *
Student Name (First Last) *
Student Date of Birth *
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DD
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YYYY
Parent Name (First Last) *
Parent Phone Number *
Street Address *
City *
Zip Code *
Date of Positive Test (day test was taken, not date the results came in) *
MM
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DD
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YYYY
Location of positive test (please be as specific as possible, ex: Norton Immediate Care Tyler Retail Village) *
Is the student currently showing symptoms? *
Required
What symptoms are present? *
Required
What date did the first symptom start? If no symptoms, type n/a *
What was the last day your student was present at school? *
MM
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DD
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YYYY
List any pre-existing conditions your student has and any daily medication taken for that condition. If none, put none. *
A copy of your responses will be emailed to the address you provided.
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