2021-2022 COVID Questions ONLY

This notification system has been set up to respond to both parent/guardian and staff questions. This link is not used to share positive tests, it’s being used as a platform to address questions ONLY. Please complete all fields so a District COVID Response Member can reach you to properly address your questions.

Please select one of the following two options: *

Please select one of the following two options: Staff COVID Questions Student COVID Questions - DO NOT SUBMIT POSITIVE COVID CASES ON THIS FORM - Positive Cases Must Be Reported to the School
Staff Name Staff Name * First Last
Staff Date of Birth Staff Date of Birth * / MM / DD YYYY
Staff Address Staff Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Staff Phone Staff Phone * - ### - ### ####
Staff School or Department (scroll down for departments) *
Administrator/Supervisor's Name Administrator/Supervisor's Name * First Last
Date of Onset of Symptoms - Staff Date of Onset of Symptoms - Staff / MM / DD YYYY
Last Day of Attendance for Staff Last Day of Attendance for Staff * / MM / DD YYYY
Copy of Positive Test Results (upload) - Staff *

Attach Files
Other Information if needed - Staff
Student Positive COVID Results

This is the description of your section break.
Student Name Student Name * First Last
Student Date of Birth Student Date of Birth * / MM / DD YYYY
Student School *
Parent/Guardian Name Parent/Guardian Name * First Last
Parent/Guardian Phone Parent/Guardian Phone * - ### - ### ####
Date of Onset of Symptoms for Student Date of Onset of Symptoms for Student / MM / DD YYYY
Last Day of Attendance for Student Last Day of Attendance for Student * / MM / DD YYYY
Copy of Positive Test Results (upload) - Student *

Attach Files
Other Information if needed - Student
Staff that is unvaccinated and exposed to person that has tested positive for COVID
Unvaccinated Staff Name Unvaccinated Staff Name * First Last
Unvaccinated Staff Date of Birth Unvaccinated Staff Date of Birth * / MM / DD YYYY
Unvaccinated Staff Phone Number Unvaccinated Staff Phone Number * - ### - ### ####
Unvaccinated Staff Address Unvaccinated Staff Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Unvaccinated Staff School or Department (scroll down for departments) *
Unvaccinated
Staff Administrator/Supervisor's Name Unvaccinated
Staff Administrator/Supervisor's Name * First Last
Last Day of Attendance for Unvaccinated Staff Last Day of Attendance for Unvaccinated Staff * / MM / DD YYYY
Copy of Positive Test Results for Unvaccinated Staff (upload)

Attach Files
Other Information if needed - Unvaccinated
Staff
Student that is unvaccinated and exposed to a person that has tested positive for COVID
Unvaccinated Student Name Unvaccinated Student Name * First Last
Unvaccinated Student Date of Birth Unvaccinated Student Date of Birth * / MM / DD YYYY
Unvaccinated Student's School *
Unvaccinated Student Parent/Guardian Name Unvaccinated Student Parent/Guardian Name * First Last
Unvaccinated Student Parent/Guardian Phone Unvaccinated Student Parent/Guardian Phone * - ### - ### ####
Last Day of Attendance for Unvaccinated Student Last Day of Attendance for Unvaccinated Student * / MM / DD YYYY
Unvaccinated Student Copy of Positive Test Results of person that you were exposed to (upload)

Attach Files
Other Information if needed - Unvaccinated Student
COVID Staff Questions
Staff Name (for question) Staff Name (for question) * First Last
Staff School/Department (for question) *
Staff Phone (for question) Staff Phone (for question) * - ### - ### ####
Staff Member Email Address *
Enter your question - Staff *
COVID Student Questions
Student Name (for question) Student Name (for question) * First Last
Student School (for question) *
Parent/Guardian Name (for question) Parent/Guardian Name (for question) * First Last
Parent/Guardian Phone (for question) Parent/Guardian Phone (for question) * - ### - ### ####
Parent/Guardian Email (for question)
Enter your question - Student *

2021-2022 COVID Questions ONLY

2021-2022 COVID Questions ONLY

Student Positive COVID Results

Staff that is unvaccinated and exposed to person that has tested positive for COVID

Student that is unvaccinated and exposed to a person that has tested positive for COVID

COVID Staff Questions

COVID Student Questions