Covid-19 Positive Notification Form Your Name First Last Email Contact Phone Number 1Contact Phone Number 2Student Name First Last Student's Date of Birth Day Month Year Student Year Group Please tick the relevant box(es) below The student has symptoms associated with Covid-19 The student has tested positive for Covid-19 The student has been instructed by NHS track and trace to self-isolate due to close contact with an individual who has tested positive for Covid-19 Date of Test Day Month Year Please provide any further information we may find usefulThe date the student was last on site Day Month Year
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