Covid-19 Incident Report - Northern School of Contemporary Dance

Name*

First Last

Student email address*

Your student bubble*

Explain the situation*

Be specific and use names, addresses and learning bubbles.

Your Leeds address*

Street Address Address Line 2 City Postcode Country

Do you have symptoms?*

What symptoms do you have?*

Have you had a test?*

What is the result?*

Please upload a copy of your test result:

Max. file size: 16 MB.

When were you last in the building and in what class?*

Any further information?