Covid-19 Online Form

Please fill in all fields and if a question is ‘Not Applicable’ write N/A

[contact-field label="Child's Name" required="1" type="name"/] [contact-field label="Child's Surname" required="1" type="name"/] [contact-field label="Child's date of birth" required="1" type="date"/] [contact-field label="Child's classroom" required="1" type="text"/] [contact-field label="Teacher's name" required="1" type="text"/] [contact-field label="Reporter" required="1" type="name"/] [contact-field label="Reporters relationship to child" required="1" type="text"/] [contact-field label="Reporters contact number" required="1" type="telephone"/]

Positive COVIDS test-RAT or PCR

[contact-field required="1" options="RAT,PCR,N/A" type="select" label="Select one"/] [contact-field label="Date of close household contact" type="date"/] [contact-field label="Date returning to school (7 days after contact as long as asymptomatic)" required="1" type="date"/] [contact-field label="Last date attended school" required="1" type="date"/] [contact-field label="Additional comments" type="textarea"/]
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