Student Remain In School (RIS) Attestation Form
Students who are unvaccinated with known exposure to someone with diagnosed or presumed COVID-19 and are considered a presumed close contact are encouraged to test at home, prior to arrival at school, on day 2 and day 5, after exposure, and report the results using the form below.
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E-posta *
Student's Last Name *
Student's First Name *
Student's School Building/Program *
Student's Grade Level *
Parent/Guardian's Name (First and Last Name) *
Date COVID-19 Test Was Administered At Home *
GG
/
AA
/
YYYY
This test was administered on Day 2 or Day 5 after the last day of exposure (please select below).
Seçimi temizle
Test Result *
I attest that I administered an at-home test for my child on the date specified above. I further attest that the test result was negative. *
Gönder
Formu temizle
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