HWES Quarantine Return

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Please complete the information below regarding your child's return to school. If you have questions regarding quarantine guidelines, please visit the District 5 website at lexrich5.org

Email *

Student's Last Name *

Student's First Name *

Teacher's Name *

Please check which applies the most to you. *

Isolation (positive or symptoms reported) - Symptoms are absent or improving, No fever for 24 hours without the use of fever reducing medications, I understand that my child will be required to wear a mask through day 10 of isolation. If unable to comply with the mask requirement, I understand my child will need to remain home for the full 10 day period.

Quarantine (close contact) - I have provided a negative test result dated on day 4 or after of quarantine, symptoms are absent, I understand that my child will be required to wear a mask through day 10 of quarantine. If unable to comply with the mask requirement, I understand my child will need to remain home for the full 10 day period.

Eliminated Quarantine - I have provided the vaccination status, symptoms are absent, I understand that my child will be required to wear a mask through day 10 of quarantine. If unable to comply with the mask requirement, I understand my child will need to remain home for the full 10 day period.

A copy/photo of my child's negative COVID-19 test or vaccination status has been sent to the Nurse's Office at czier@lexrich5.org.

Negative COVID-19 test provided

Vaccination Card provided

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Parent Signature (by typing your name, you are signing this document) *

Parent Contact Number *

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