JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
COVID Case Submission
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Phone Number
*
Your answer
School student attends
*
Hanover Green
Lee Park
Memorial
Lyndwood
High School
Reason for completing this form
*
Student named above has tested positive for COVID
Student named above has a household member that tested positive for COVID
Student named above has been identified as a close contact of someone that tested positive for COVID
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hanover Area School District.
Report Abuse
Forms
