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FHC Covid Reporting Form

indicates a required answer

Please make sure to read the most current version of our COVID-19 Policy on our website before reporting. 

1. *

Exposed individual(s)

2. *

Parent Name

3. *

Email 

4. *

Phone Number 

5. *

Are you reporting a COVID exposure or postive test?

Positive test Exposure
6. *

What was the date of exposure or positive test?

7. *

Does your student have symptoms?

Yes No
8. *

Your plans for testing are: 

Already tested positive Test ON or AFTER the 5th day from exposure
Not testing, waiting 10 days after exposure
9. *

If reporting an exposure and your child will attend FHC with a mask during the 5 days before testing, what are your lunch period plans, per the COVID Policy? 

My child doesn't have a lunch period I will join my child on campus for lunch
We plan to stay at home n/a, reporting a positive test
10. *

If you're reporting a positive test, click here to agree to contact FHC for approval and to discuss your lunch period plan in the event you wish to return to campus before 10 days have passed, per the COVID Policy. 

Not reporting a positive test I agree to contact with lunch plan
We plan to stay home 10 days
11. 

Please provide us with any other relevant information here: