Report a COVID-19 Positive Case

This form allows parents and carers to report a COVID-19 positive test result of a student.

Student Name(Required)

First Last

Year(Required)

Room(Required)

Name of Siblings

First Last

Name

First Last

Name

First Last

Date student tested positive(Required)

Date student last attended school(Required)

Parent / Carer Name(Required)

First Last

Parent / Carer Contact Number(Required)

Parent / Carer Email(Required)

Parent / Carer Signature(Required)