23-24 Breakthrough Scholar Covid-19 and Communicable Illness Reporting Form
Breakthrough's health and safety protocols are designed to mitigate against the spread of contagious illness at school, and to help us respond appropriately when cases do occur. Please complete this form as soon as possible after your scholar receives a positive test or diagnosis for a COVID-19 or another communicable (contagious/infectious) illness. Thank you for helping us keep our school communities healthy!
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What is your scholar's name? *
What is your name and relationship to the scholar?
What is the best phone number to reach you? *
What is the best email to reach you? *
What campus does your scholar attend? *
For which communicable (contagious/infectious) illness has your scholar received a positive test and/or diagnosis? *
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