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BSD Student Reporting for Covid 19 2022-2023
Complete this form if your student has tested positive for Covid 19.
Please complete a separate form for each student receiving a positive test result.
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* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Campus
*
BHSC
BJHSC
Eagle Mtn
Sulphur Rock
West
WRA
Preschool
Student's date of birth
*
MM
/
DD
/
YYYY
Last date on campus
*
MM
/
DD
/
YYYY
Date of first symptoms
*
MM
/
DD
/
YYYY
Date of test
*
MM
/
DD
/
YYYY
Date test results received
*
MM
/
DD
/
YYYY
Where was test performed?
*
Your answer
Type of test performed
*
Rapid
PCR - send off
Parent/Guardian Name
*
Your answer
Parent/Guardian contact number
*
Your answer
Please list any siblings or household members who attend Batesville Schools.
Your answer
Please list any extracurricular activities the student attended within 48 hours prior to onset of symptoms or while symptomatic.
Your answer
Please list any Batesville Schools student or staff who came into close contact with the student during the 48 hours prior to onset of symptoms or while symptomatic outside of the classroom/extracurricular activity setting.
Your answer
If you have any questions or need immediate assistance please contact the Covid Point of Contact, Nurse Crystal Bullard by one of the following.
Office 870-793-0630 ext 1901
Cell 870-834-9634
Email
cbullard@gobsd1.org
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