COVID-19 Test Results

COVID-19 Test Results

Complete the form below with a copy of your COVID-19 test results. Records will be kept on file with the Heath and Wellness Coordinator.
Name*

First NameLast Name
Your Relationship to the AAC*
Date of COVID-19 Test

MonthDayYear
Date
Copy of Test Results

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Attach a photo of your immunization record. Cancelof
All information entered is confidential.

Students, Faculty, and Staff are required to consent to and cooperate with the AAC Success and Wellness Plan and agree to protocols communicated. To find a copy of our COVID-19 Success and Wellness Plan, visit www.artacademy.edu/covid19
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