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VCMS COVID-19 Exposure Reporting / Informes de exposición VCMS COVID-19

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Para traducir a un idioma diferente, use la opción de traducción ubicada en la parte superior derecha de la pantalla.

Please remember that you only need to fill out this form if you are reporting a Covid-19 exposure.

Are you a:*

Answer Required

VCMS staff member

VCMS community member (parent/guardian)

Staff member/Parent/guardian first and last name:*

Answer Required

Staff member/Parent/guardian email address:*

Answer Required

Staff member/Parent/guardian cell phone:*

Number Required

Student first and last name:*

Please answer "N/A" if you are a VCMS staff member.

Answer Required

Student grade level:*

Answer Required

6th

7th

8th

Not applicable as I am a VCMS staff member.

Date of last contact with Covid-positive individual*

Answer Required

Is this person a member of your household?*

Answer Required

Yes

Please list any siblings at VCS schools (VCES or VCMS):

Answer Required

Confirmation Email

Email Required