Activities Director - Mr. Pahl - Ulen-Hitterdal Public Schools

Shortened Quarantine Request e-Form

Per the new MDH close contact guidelines, students who have one close contact experience may be considered for an earlier return date to school if they meet certain criteria. To request an early return for your child, please fill out the following areas and provide any necessary supporting documentation. For ALL early returns, students must have no symptoms and have had only one close contact exposure.

* If a houshold member is positive for COVID, you do not qualify for early return and need to quarantine for the full 14 or 24 days depending on isolation within the home.*

Student Name:

Parent/Guardian Name(s):

Age:

Grade:

School:

10 DAY QUARANTINE REQUEST (return after finishing 10 full days of quarantine)

Check the following that apply to your child (ALL must be checked to qualify):

Required for 10 Day Quarantine Check all of the following that apply:

1) My child has no symptoms
2) My child has NOT tested positive for COVID
3) No one in my child's household has tested positive for COVID
4) After the 10 day quarantine, I agree to monitor my child for symptoms through day 14 and keep them home if ANY symptoms would appear

7 DAY QUARANTINE REQUEST (return after finishing 7 full days of quarantine)

Check the following that apply to your child (ALL must be checked to qualify):

Required for 7 Day Quarantine Check all of the following that apply:

1) My child has been tested for COVID-19 at least five full days after their close contact exposure, and the test is negative. To qualify, test must be a PCR test- please check with your doctor. Negative results with appropriate date (5+ days after exposure) must be provided to the school with this form. *** Please note, day one starts the day after exposure. Ex: close contact occurred on Friday at 3pm, earliest date of test could be Wednesday at 3pm (Sat= day 1, Sun= day 2, Mon=day 3, Tue=day 4, Wed=day 5)
2) My child has no symptoms
3) My child has NOT tested positive for COVID
4) No one in my child's household has tested positive for COVID
5) After the 7 day quarantine, I agree to monitor my child for symptoms through day 14 and keep them home if ANY symptoms would appear

If you're completing the 7 day request, please submit a copy of your NEGATIVE COVID results to:
UH: kpotter@ulenhitterdal.k12.mn.us
NCE: tracyj@nce.k12.mn.us

Failure to do so will make this submission null in void and revert to the 10 day quarantine.

Name of Parent/Guardian Completing this Form:

*

Date (month/day/year):

*

Phone Number of Parent/Guardian:

*

Email of Parent/Guardian (optional):

* Indicates Required fields.

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