23-24 Staff Self-Reporting Form

Staff Self-Reporting Form

Due to the ongoing COVID-19 Pandemic, we encourage all staff to self report if they have tested positive with COVID-19. Duncanville ISD is in compliance with all national (CDC), state (TEA) guidelines to ensure the safety of all students and staff.
Name*

First NameLast Name
Position/Title*
Staff Personal Phone Number*
Please enter a valid phone number.
Staff Email*
example@example.com
Staff Campus/Department*
Circumstances Reported*

Tested Positive for COVID-19Hospitalized due to COVID-19
Please upload documents confirming a positive COVID-19 test result or a negative COVID-19 test result.

Cancelof
Name of Person Reporting (if different from staff member)

First NameLast Name
Reporter Email
example@example.com
Reporter Phone Number
Please enter a valid phone number.
Relationship to Staff Member
Should be Empty: