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Report a COVID-19 Case
Parents of PK-12 students, please complete this form and also contact your child's coach or sponsor if they are in 7-12 grade extra-curricular activities.
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* Indicates required question
Email
*
Your email
Name & phone number of person making this report
*
Your answer
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Building Student Attends
*
West
Northstar
KMS
KHS
Grade Level & Teacher if PK-5 student
*
Your answer
Student
*
Tested Positive
Exposed to a positive case in the household
Exposed to a positive case outside the home
Date of Test or Exposure
MM
/
DD
/
YYYY
Student has the following symptoms
*
Headache
Fever
Loss of taste or smell
Cough
Congestion
Body Aches
No symptoms
Other:
Required
Date of Return provided by Doctor or Public Health
Your answer
Names & grades of other children in the home that attend KCSD schools.
Your answer
Please share any other information that would be helpful or questions.
Your answer
Would you like a call from KCSD Nurse, Angie Mitchell after the holidays?
*
Yes
Not necessarily
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