Student Online Contact Tracing Form

Complete the form below for the student who tested positive for COVID-19. One form must be completed for each student who tested positive. If a staff member tested positive for COVID-19, he/she should complete the Staff Contact Tracing form.

Student First Name
Student Last Name
Student ID#:
Date of Birth (mm/dd/yyyy):
Parent Name (full name)
Parent Email Address
Parent Main Contact Phone Number
Student School of Attendance:
Current Grade:

Student Home Address:
County (Will, DuPage, Grundy, etc.):

Date of COVID-19 Test? (mm/dd/yyyy)

Type of Test?
Date you received the test results? (mm/dd/yyyy)
Name of Lab?
Address of Lab?

What has your child attending in person for in the past week?

What was the last day the student was in a District building? (mm/dd/yyyy)

Does your child currently ride the bus?

Has the student ever had symptoms?
If yes, what was the first date of symptoms? (mm/dd/yyyy)