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Prentiss County School District Title 1 Teacher Survey
This form will be used when budgeting for Title funds for 2022-23 when they come available
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Email
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Your email
Option 1
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I need someone from Prentiss County School District to contact me to discuss that I have had Direct Close Contact to a COVID-19 Person Person. I have tested positive for COVID-19, or someone in my household has tested positive for COVID-19.
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I the EMPLOYEE of PCSD Tested who has Positive for COVID-19
Someone in my household has Testing Positive for COVID-19
I have had direct exposure for more than a 15 minute time period/with or without a mask/facial covering and it has been reported that the individual has tested positive.
I verify that I am an employee of Prentiss County School District
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Option 1
Required
What campus are you located at in Prentiss County School District?
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Hills Chapel
Jumpertown
Marietta
New Site
Thrasher
Wheeler
Prentiss County School District Career and Technical Center
Prentiss County School District Superintendents Office
Required
Employee Name and Contact Information (telephone number)
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Your answer
In the Past Three Days Please list all the following employees and possible students whom you have been six (6) feet of a COVID-19 Positive Person with or without a mask/facial covering for longer than a 15 minute period.
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Your answer
If you have tested positive for COVID-19, what date did the testing occur?
MM
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DD
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YYYY
What date was the testing COVID-19 confirmed by your local primary care provider?
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DD
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YYYY
Have you spoken with your administrator at your school to set up to have a SUB? (Yes/No/Not Applicable to my position) What is that Substitutes name?
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Your answer
Do you have a child in Prentiss County School District? (Yes/No/NA)If so have you completed the form for your school to notify contact tracing?
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Your answer
Date
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MM
/
DD
/
YYYY
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