Close Contact Form
Your child has been identified as a close contact of a person who has tested positive for COVID-19. Please complete this form. Thank you.
Sign in to Google to save your progress. Learn more
Name *
Date of Birth *
MM
/
DD
/
YYYY
Home Address: Street number and name *
Home Address: City *
Home Address: Zip Code *
Home Phone Number *
Vaccination Status *
If your child had Covid, please indicate the date of symptom onset or positive test:
MM
/
DD
/
YYYY
Your child may continue to attend school if they are symptom free and:
1. They are fully vaccinated OR
2. They are not fully vaccinated but they follow the Test-to-Stay program as described below
Options for what to do next:
• If applicable, and if you have not already done so, please send a picture of your child's vaccination card to Veronika Lisuk.    

• If you child is not fully vaccinated, your child may continue to attend school if they participate in the Test-to-Stay program.  

• If your child is not fully vaccinated and you do not want your child to participate in the Test-to-Stay program, your child will need to quarantine for 10 days after exposure. It is recommended to get tested on Day 5 post-exposure.
Test-to-Stay Program
Under the Test-to-Stay Program, your child may complete a 7-day modified quarantine in which they may leave home only to attend school. They are not permitted to participate in  community activities during this time.  Your child must be tested for COVID-19 as soon as possible after receipt of this notice AND on Day 5 after exposure. Your child may continue to attend as long as they are symptom free and test negative for COVID-19.  
Check to acknowledge that you've read and understand the guidelines. *
Required
Which quarantine option are you choosing for your child? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms