Positive Covid Case 21-22
Please complete this form if your child has tested positive for COVID. Also please notify the school asap. Please either call 914-667-4063, dojo, or email at principal@ourladyofvictoryschool.org
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Child Last Name *
Child First Name *
What is your child's date of birth? *
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Address - complete with apt # and zip code *
Contact telephone number for you *
Parent(s) name(s) *
What (if any) afterschool sports does your child with COVID-19 participate in? *
Does your child with COVID-19 participate in before/afterschool care? *
Does anyone living with this child with COVID-19 attend an Arch school? (either write "No", or provide name of person, school, and grade) *
Does your child have a known/suspected source of exposure to COVID-19 (e.g. friend/family/classmate recently diagnosed with COVID-19)? If so, please provide details *
When did your child's symptoms start? If there were no symptoms then write none. *
What was the date of the positive test? (the date of the positive test is the date that the test was taken, not the day you get the results) *
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Where was your child tested? Please include name of facility, address, and phone. If you used a home test, write home test. *
What type of test did your child take? *
Is your child vaccinated? *
If your child is vaccinated which vaccine does your child have? *
Has your child previously had COVID? *
Child's Grade *
How does your child get to/from school? (school bus, driven with household members only, carpooled, public transit, other) *
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