Dar-us-Salaam
Covid-19 Test - STAFF
NOTE: If you tested at Al Huda School, you do not need to submit this form. We have received a copy of your results.
NO RAPID or AT-HOME Tests
Staff Name
*
First
Last
Email Address
*
Date of Birth
*
MM
/
DD
/
YYYY
Date of Test
*
MM
/
DD
/
YYYY
Upload Test Result (scan/photo/PDF)
*
What was the result of the Covid test?
*
NEGATIVE
POSITIVE
Do Not Fill This Out
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