CLV Reporting of COVID Positive

Reporting COVID Positive of CLV Staff & Students

Please use this form to report to CLV positive results from COVID-19 test administered in a lab or at home

For more information about isolation and quarantine, please visit the Cattaraugus County Health Department's website at https://www.cattco.org/coronavirus

1. First and Last Name of person completing this form: *This question is required.

2. Phone Number: *This question is required.

3. Email (Required for At-Home Learning Plans; Confirmation of Date to Return, 5 Day Isolation Check-In): *This question is required. This question requires a valid email address.

4. Current Address: *This question is required.

5. What are you reporting? Positive COVID-19 Individual or Close Contact with a Positive? Please check all that apply. *This question is required.

Student: POSITIVE for COVID-19
Staff: POSITIVE for COVID-19