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Staff COVID Test Attestation Form
A COVID test must be administered and test results submitted no later than Friday at 1:00 PM.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
School Site
*
Choose
Cresson
Jersey
Lakeland
Lakeview
Paddison
Studebaker
William Orr
Lake Center MS
Lakeside MS
District Office
Date Tested
MM
/
DD
/
YYYY
COVID Test Result
*
Negative
Positive (Immediately contact your supervisor if positive.)
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