LISD 2022 Return from Winter Break Survey

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Lancaster ISD staff and administration will continue to monitor the status of the COVID-19 pandemic. All of our efforts are to keep students, parents and staff safe as we return to school in January 2022.

Email *

First Name *

(legal name)

Last Name *

(legal name)

Campus/Building Location *

Has anyone in your household tested positive for COVID-19 in the last ten (10) days? *

Yes

If yes, please enter your last date of exposure to the positive case below:

YYYY

Have you been diagnosed with COVID-19 in the last ten (10) days? *

Yes

If yes, date of symptom(s) onset:

YYYY

Optional question #1- In order to assist with planning future vaccination clinics in our community, please consider answering the following questions: Are you fully vaccinated (including booster)?

Yes

I wish not to disclose

Clear selection

Optional question #2: If not fully vaccinated (with booster), have you received your 1st dose?

Yes

I wish not to disclose

Clear selection

Optional question #3: If not fully vaccinated (with booster), have you received your 2nd dose?

Yes

I wish not to disclose

Clear selection

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