Student Positive COVID Reporting Form 22-23

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Student Positive COVID Reporting Form 22-23

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Email *

Student Name *

Select what school your child attends by clicking on the box below the school name (which is your school nurse's email). *

Parent/Guardian Name *

What was the date your child was tested or the date symptoms began (whichever came first)?
*

MM

/

DD

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YYYY

A copy of your responses will be emailed to the address you provided.

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