Positive COVID Case Reporting Form
Reporting Test Results
Please complete the form below if you have tested positive for COVID-19 during the 2023-2024 school year. All information is kept confidential with the School Nurse. Absences will be excused as per protocol. Please see email after submitting this form.
Name of individual (tested positive):
*
First Name
Last Name
Please provide the best email to receive information regarding school protocol:
*
example@example.com
Student's school email:
example@example.com
Grade:
*
9
10
11
12
Staff
Date of Positive Test = Day Zero:
*
-
Month
-
Day
Year
Date
Please upload a photo of your positive result below:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Determining the Return to School Date:
Day zero = date of test or onset of symptoms
Day 1-5 = days of isolation
Day 6 = Return to School
Day 6 = Return Date:
*
-
Month
-
Day
Year
Date
Isolation Guidelines:
Isolate for a full 5 days after a positive test result (day zero is the date of the positive test). You may return to school on DAY 6 after the positive test if: you are fever-free for 24 hours without the use of medication and your symptoms are improving; or you never had symptoms. You should wear a mask around others for 5 additional days after the isolation ends.
Questions?
Please call the Health Office at 413-283-9701 x256 or email dunaj@pathfindertech.org.
Submit
Should be Empty: