Heritage Elementary COVID Positive Reporting & Absence Notification

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This form is for COVID POSITIVE cases ONLY. To report exposures and other illnesses or absences, please call the attendance line at 303-387-6727.

Please answer ALL questions below to help us streamline the COVID communication process for families, staff, and students.

Parents: please complete this form in its entirety for each individual that tests positive for COVID-19. In alignment with current CDC, CDPHE, and Douglas County Department of Health guidance, an individual that tests positive for COVID-19 should isolate for 5 days from the day that symptoms started, or if asymptomatic, 5 days from the date tested.

If symptoms have improved after 5 days, and the individual has been fever free for 24 hours (without the use of fever-reducing medications such as Tylenol or Advil), they may return to school. Day 0 is EITHER the date that symptoms started or, if asymptomatic the date tested for COVID-19. Example: If symptoms begin on January 13th, the 5 day isolation period would go through January 18th and the individual could return to school/work/activities on January 19th, while wearing a mask for an additional 5 days.

Last Name *

First Name *

Student Grade and Teacher *

01/17/22Last date in school *

YYYY

Is your student experiencing symptoms? If yes, please list *

Does your student attend BASE, band, orchestra, or other extracurricular activities (chess, lego, etc.) at Heritage? If yes, please list: *

Date of symptom onset (or if asymptomatic, test date) *

YYYY

Date of test *

YYYY

Type of test *

Please enter student's day ZERO (date of symptom onset OR date test was taken if no symptoms) *

YYYY

Add 5 days to date listed above. THIS IS THE LAST DATE OF ISOLATION. Your student can return to school/activities the following day IF symptoms are improving AND fever free *

For example, if symptom onset is 1/13, then student's last day of isolation is 1/18 (13+5=18). Student could return on 1/19.

YYYY

Parent email and phone number *

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