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Submit COVID-19 Questions and Information
Please complete the following information and a staff member will be in touch with you.
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* Indicates required question
Email
*
Your email
Parent/Guardian Name
*
Your answer
Phone number to contact Parent/Guardian
*
Your answer
Student's name
*
Your answer
Student's grade
*
Choose
Preschool
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Which group is your student assigned to?
*
Green Group
White Group
Digital Academy
Other:
Does your student currently have any symptoms of COVID-19? (Check ALL that apply)
*
fever
cough
shortness of breath
headache
body aches
loss of smell/taste
sore throat
nausea/vomiting
diarrhea
chills
fatigue
congestion
No Symptoms
Required
Has your student been tested for COVID-19?
*
Yes
No
Is someone in your home waiting for results of a COVID-19 test?
*
Yes
No
Has your student had close contact with a COVID-19 positive person (within 6 feet of person for 15 minutes or longer with a 24 hour period)?
*
Yes
No
Does your child participate in sports
*
Yes - Northridge School (Grades 7-12)
Yes- NYAA (Grades K-6)
Yes- Other outside sports organizations
No- does not participate
What questions do you have for the nurse or administrator?
Your answer
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