JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Pupil COVID Tracker
Please use this form to tell us if your child tests positive on a lateral flow or a PCR test OR someone in your household tests positive on a lateral flow or a PCR test (your child can still come to school).
This is so that we can be vigilant and track any patterns of infection.
If your child has symptoms and you are taking them for a PCR test you should treat this as an illness and phone the school as normal.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Child's First Name
*
Your answer
Child's Surname
*
Your answer
Child's Form Group
*
Nursery
RPalm
ROrchid
1Lemon
1Rowan
2Beech
3Elder
3Maple
4Ash
4Elm
5Oak
5Sycamore
6Leam
6Thames
7Derwent
7Liffey
8Avon
8Taff
9Clyde
9Eden
10Foyle
10Neath
11Mersey
11Wensum
12Tigris
12Orinoco
13Congo
13Ganges
Name of Parent
*
Your answer
Please indicate whether your child tested positive on a lateral flow OR a PCR test OR if someone in your household tested positive on a lateral flow or a PCR test (your child can still come to school).
*
My child tested positive on a lateral flow
My child tested positive on a PCR
Someone in your household tested positive on a lateral flow or a PCR test
If someone in your child's household has tested positive on a lateral flow or a PCR test, please put the details here
Your answer
If you child tested positive on a lateral flow, please let us know the date here
MM
/
DD
/
YYYY
If your child tested positive on a PCR test, please put the date of the test, or the date your child's symptoms started (whichever is earlier)
MM
/
DD
/
YYYY
If your child has tested positive on either a lateral flow or PCR test please put their isolation end date here
MM
/
DD
/
YYYY
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Reach Academy Feltham.
Report Abuse
Forms