Covid-19 Positive Notification Form

Your Name
First Last
Email
Contact Phone Number 1
Contact Phone Number 2
Student Name
First Last
Student's Date of Birth

DD
MM
YYYY
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

DD
MM
YYYY
Please provide any further information we may find useful
The date the student was last on site

DD
MM
YYYY

Herns Lane, Welwyn Garden City, Herts, AL7 2AF

Telephone: 01707 351350
Absence Line: 01707 351350 Extn: 315
Email: admin@ridgeway.herts.sch.uk

Ridgeway Academy is part of the
Alban Academies Trust