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* 1. This is to. confirm that you are indeed reporting a postive COVID-19 case to the Ardsley school district.  If you answer "No", please do not complete the survey.

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* 2. The positive COVID individual is

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* 3. First Name of Individual

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* 4. Last Name of Individual

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* 5. Date of Birth (DOB) of individual

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* 6. When was the test taken (Date and Approx. Time) 

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* 7. Was there any symptoms of COVID at all leading up to taking the COVID test? 

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* 8. If Yes or Unsure/Somewhat in Q8 please further explain:

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* 9. What was the last date on the Ardsley campus

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* 10. AFTER YOU SUBMIT THIS SURVEY YOU WILL RECEIVE A REPLY EMAIL - PLEASE  CALL PHONE NUMBERS ON THE LIST UNTIL YOU DIRECTLY TALK WITH SOMEONE.  This will allow us to act quickly and support you and your family during this time.

OPTIONAL - Add any additional pertinent information below.you for completing this survey.  The information will be CONFIDENTIAL and only used to assist the Westchester Department of Health in their and our contact tracing efforts. 

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