Hillcrest Middle COVID Reporting Form

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Please fill out the form below to report COVID positive cases or known COVID exposures. An administrator from the school will contact you directly to gather further information. If you are reporting multiple cases, please complete one form for each COVID positive or exposed student.

Email of Parent *

Last Name of Student *

First Name of Student *

Grade Level *

COVID-related issue: *

Student has tested positive for COVID

Student has been exposed to someone who is COVID positive

Student is showing symptoms and is being tested for COVID (no results yet)

Other:

Please list any students or school staff who MAY be a close contact to the COVID positive person:

Please include any additional information you would like to share with us, if applicable:

How would you prefer we contact you: *

Phone

Either is fine

Best parent phone number for us to call: (please include area code) *

Best email address for us to forward information to. *

I have an active Parent Backpack account. *

Yes

Thank you for filling out this form.

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