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LISD COVID-19 Health Notification Form
Formulario de notificación de salud LISD COVID-19-
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* Indicates required question
Email
*
Your email
Parent/Guardian Name:
*
Nombre de Padre/Guardian:
Your answer
Phone Number:
*
Número de Teléfono
Your answer
Student First Name
*
Primero Nombre de Estudiante
Your answer
Student Last Name
*
Apellido de Estudiante
Your answer
Student Username (Chromebook login)
*
Nombre de Usuario de Estudiante (Inicio de Sesión de Chromebook)
Your answer
Student Date of Birth
*
Fecha de nacimiento de Estudiante
MM
/
DD
/
YYYY
Home Address:
*
Dirección de Domicilio
Your answer
What campus does this student attend?
*
¿A qué escuela asiste este estudiante?
Carver
Bluebonnet
Clear Fork
Navarro
Plum Creek
Strawn
Junior High
High School
Pride
Grade:
*
Grado
Choose
PK
K
1
2
3
4
5
6
7
8
9
10
11
12
Has this student tested positive for COVID-19?
*
¿Este estudiante ha dado positivo por COVID-19?
Yes/ Si
No
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