Student-Positive COVID Case Report - Summer School
Please complete this form to report a positive student COVID case if your child attends summer school at Susan E. Wagner High School
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Student First Name *
Student Last Name *
School Name *
Student OSIS# (ID #) *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
Student's Last Day in the Building *
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DD
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Date of Positive COVID test *
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Type of Test Taken *
Date Symptoms Started *
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/
DD
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Student's Symptoms *
Required
Reason for Test *
Did the student test positive in the last 90 days? *
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