COVID Data Entry | School Health Room

Return Early for Positive Individuals Request Form
Isolation is required for all positive cases of COVID-19 regardless of vaccination status.

Families and staff may utilize the early return from isolation option if they meet ALL the following criteria:
- Positive test results must be submitted
- At least 24 hours since the person had a fever without fever reducing medications;
- All symptoms of COVID-19 are significantly improving
If the above criteria is met, please complete this form below. The submission will be reviewed to determine if the criteria for this shortened isolation option are met and you will receive an email with a new return date. Please do NOT send your child to school until you have received an email with a new return date. The school will be notified of all changes in return dates for attendance coding purposes. COVID and FLU absences are exempt from seat time make-up at the high school level.
Student or Staff Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
School*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian/Staff Email*
example@example.com
Upload Test Results (not required if already submitted test results to the Covid Call Center or had a positive test result at school/Belleview)

Browse Files
Please upload test results here. Possible file types: pdf, doc, docx, jpg, png, gif Cancelof
Fever free for 24 hours without fever reducing medication*

YesNo
All COVID-19 symptoms have improved significantly*

YesNo
I understand that students and staff member are REQUIRED to wear a mask to school until their 10 day isolation period has ended. If the student or staff member does not wear their mask appropriately throughout the school day except when eating/drinking, parents will be asked to pick their child up from school so they can complete the remaining isolation period at home. Please review with your child the proper way to wear a mask and the requirement to wear the mask.

By signing the form, I agree to the above statement and understand the requirements to wear a mask during isolation.
Name of Parent/Guardian/Staff Signing Form *

First NameLast Name
Signature*

Clear
Should be Empty:

Return Early for Positive Individuals Request Form