Post-Quarantine Re-entry Form

Please complete the form for each child who is out due to Covid related issues.

Parent's Name*

First Name

Last Name

Parent's Email*

Student's Name*

First Name

Last Name

Student Grade*

My child has been symptom free and fever free for 24 hours without the use of fever reducing medication.

My child has been home due to:*

Showing possible Covid symptoms Exposure to a symptomatic person tested Covid NEGATIVE Being tested Covid positive Exposure to a symptomatic or asymptomatic non-household member tested Covid positive Exposure to an asymptomatic household member tested Covid positive Exposure to a symptomatic household member tested Covid positive Quarantining out of an abundance of caution

I affirm that my child has tested NEGATIVE on a Covid PCR test

I affirm that my child has not been exposed to anyone with a known Covid POSITIVE diagnosis in the last 10 days

I affirm that my child has quarantined 10 days since the onset of his/her covid symptoms or being tested positive, and has been symptom and fever free for at least 24 hours without medication

I affirm that my child has quarantined for 10 days from their last exposure to the COVID positive household member.

I affirm that my child has quarantined for 10 days since the Covid positive household member's test date.

Were you required to get a negative result for anyone in your family?*

Yes No

PCR Tests Only

Upload test results of the student or family member who got tested (PCR tests only)*

No File Chosen

File uploads may not work on some mobile devices.

Signature*

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Use your mouse or finger to draw your signature above