Home Test Results (Students)
This form is to report results of home testing for COVID-19 for students at Churchill Academy & Sixth Form
Sign in to Google to save your progress. Learn more
What is the student's first name? *
What is the student's surname? *
What is the student's date of birth? *
MM
/
DD
/
YYYY
What year group is the student in? *
Which house is the student in?
Clear selection
When did the student complete this home test for COVID-19? *
MM
/
DD
/
YYYY
What time did the student complete this home test for COVID-19?
Time
:
What was the result? *
If your test was POSITIVE please inform the Academy immediately via email (churchill@churchill-academy.org) and/or telephone (01934 852771). You should also book a confirmatory PCR test to verify the result online at https://www.gov.uk/get-coronavirus-test, and inform the Academy of the PCR test result when you receive it.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Churchill Academy. Report Abuse