Students Online Contact Tracing Form

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:

City:

State:

Zip:

County (Will, DuPage, Grundy, etc.):

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

Type of Test?

Lab Test Home 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?

None, my child has not attended in person the past week
In-Person School
WILCO
Behind the Wheel
Athletics
Activities

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

Does your child currently ride the bus?

YES NO

Has the student ever had symptoms?

YES NO

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