Centerville Schools COVID-19 Reporting
4/27/22 We are NO LONGER using this form to report COVID cases. Please just notify the nurse in the building.


Any student, staff member or volunteer/visitor who has tested positive for COVID-19 must stay home and complete the following form WITHIN 24 HOURS.  

New as of February 11, 2022 ONLY for PRESCHOOL. Any PRESCHOOL student, staff member, or volunteer who has been in close contact with someone with COVID-19 (within 3 feet of an infected person for a total of 15 minutes or more over a 24-hour period) must stay home and complete the following form WITHIN 24 HOURS.

Once the form is received, a school nurse or staff member from our Student Services Department will provide isolation and/or quarantine guidance from Public Health - Dayton & Montgomery County.
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Name of person filing report: *
Phone number of person filing report: *
I am completing this form for a: *
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