JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
COVID-19 Home Test Kit Results
Use this form to register the test results of your home test kit
You will need the code found on the front of each test strip
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Forename
*
Your answer
Student Surname
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Student Form Group
*
Choose
7CMO
7LJ
7NJ
7LH
8SC
8AD
8HH
8LC
Test strip code
*
Your answer
Test Result
*
Positive
Negative
Void
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of James Bateman Junior High School.
Report Abuse
Forms