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COVID-19 Reporting Form

Please complete the form below with information for the affected individual. Required fields marked with an asterisk *

Campus you attend for work or study*
Answer Required
How do you know COVID-19 is present? (Check all that apply)*
Answer Required
What was your process for confirming COVID-19? (Check all that apply)*
Answer Required
Exposure information: In the 14 days prior to your illness or diagnosis, have you had any of the following exposures? (check all that apply)*
Answer Required
If you were exposed to an individual known to have COVID-19, please tell us what type of contact. (Check all that apply)
Answer Required
Have you had symptoms related to COVID-19? (Check all that apply)*
Answer Required
Have you reported physically to any of the Invictus High School Campus locations in the last 14 days? (Check all that apply)*
Answer Required