Home Covid-19 Testing Results
Use this form to report your home testing results
Sign in to Google to save your progress. Learn more
Please give your full name *
Date of Birth
MM
/
DD
/
YYYY
Year Group or Staff Role *
What date did you take the test on? *
MM
/
DD
/
YYYY
What time of the day did you take the test? *
Was your result... *
If positive, please ensure you self isolate and arrange a confirmatory PCR test as soon as possible.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Outwood. Report Abuse