COVID-19 Positive or Close Contact Report
Parents- please complete this form and a nurse/ contact tracer will contact you about the length of quarantine.
登入 Google 即可儲存進度。瞭解詳情
電子郵件 *
Student's Name
Date of Birth
MM
/
DD
/
YYYY
Teacher Name
Parent Name
Parent Email
Parent Phone Number
Has the student been in close contact with a positive COVID-19 case or has the student received a positive COVID-19 test?
清除選取的項目
Date the student was last at school
MM
/
DD
/
YYYY
Close Contact:  Date of last contact with the COVID positive person
MM
/
DD
/
YYYY
COVID Positive:  Date of Positive Test
MM
/
DD
/
YYYY
Date Symptoms started (if symptomatic)
MM
/
DD
/
YYYY
If your child is a bus rider, please list the bus number
Are there any other close contact you are aware of?
Are there any other family members in CCSD?  If so, please list their name and school.
提交
清除表單
請勿利用 Google 表單送出密碼。
這份表單是在 Charleston County School District 中建立。 檢舉濫用情形
Google 表單