Parent Travel Information Form re: Coronavirus
Please complete this form in order to notify our school nurses about any travel that you, or anyone in your household, completed in the last 30 days and/or have planned through the end of the school year. For additional information from the CDC regarding travel warnings/restrictions, please click here: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html.  

Please edit your submission or notify the school nurse if your plans change after you submit this form.
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Email *
First name
Last name
Name of child(ren) currently at Golda Och Academy
Have you or anyone in your household traveled anywhere outside the US in the last 30 days? If yes, please let us know where, which members of the household traveled and the specific travel dates.
Date(s) of past/future travel (please list the first day of travel)
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Date(s) of past/future travel (please list the last day of travel)
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Are you or any member of your household planning any travel outside the US between now and the end of the school year (June 17, 2020)? If yes, please let us know where, which member of the household is traveling and the specific travel dates.
Is there anything else we should know about your (or members of your household) past/future travel, including travel to areas inside the US that have known outbreaks? Please use this space to explain.
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