Covid Infection Form

Child's Full Name* Tutor Group*

Has your child had a positive COVID test result?*YesNo

If yes:

	Date symptoms began	Date of test	Date they are due to return to school - no earlier than the 11th day after their first symptoms	Full names of staff and students who they have had close contact with ie. sat next to in lessons, spent break with, been in close proximity with at any time

If no:

	Reason for Self Isolation	Date they are due to return to school

Parent Name* Email Address*

St Wilfrid's Catholic School