COVID Report
Please complete this form if your son/daughter has developed symptoms or tested positive for COVID-19. We will review this information and reach out to you regarding quarantine timelines, school work, etc. Thank you in advance for helping to keep everyone safe and healthy.
Sign in to Google to save your progress. Learn more
Email *
Your name and relation to student. *
Best phone number to reach you. *
Student ID # *
Student Last Name *
Student First Name *
Date Student Was Last In School *
MM
/
DD
/
YYYY
Date Student First Developed Symptoms
MM
/
DD
/
YYYY
Date Student Tested Positive(if was tested)
MM
/
DD
/
YYYY
Is student currently involved in sports or an after school activity? Please specify.
Any additional information or questions....
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Township High School District 214. Report Abuse
Google Forms