Report COVID-19 Test Result

The COVID-19 test must be an FDA-authorized viral COVID-19 test including PCR or Antigen test. Home tests are acceptable. Forms will not be accepted unless a copy of the test result is submitted as well.

Name Name First Last
Grade Level
Test Type

Test Type PCR Test Antigen Test Over the Counter Test
Date Test Administered Date Test Administered / MM / DD YYYY
Upload a photo or copy of the test result

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