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Student Vaccination Status Disclosure to Expedite Contact Tracing
The San Marino Unified School District is requesting parents or guardians to voluntarily disclose their child’s COVID vaccination status to expedite contact tracing. Having the vaccination status would help COVID support staff expeditiously follow the appropriate LACDPH protocols. This information is being sought for the purposes of contact tracing only and will not be used for any other purpose. One response per student.
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School:
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San Marino High School
Huntington Middle School
Carver Elementary School
Valentine Elementary School
Student First Name
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Your answer
Student Last Name
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
SMUSD Student Number
Optional: 5-digit SMUSD Student ID Number
Your answer
Grade Level
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Choose
TK
K
1
2
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I voluntarily disclose:
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Per LACDPH, a student is considered "fully vaccinated" 2 weeks after completing the primary series of the COVID-19 vaccine (e.g., 2nd dose of Pfizer).
My student is fully vaccinated for COVID-19
My student is NOT fully vaccinated for COVID-19
I choose NOT to disclose my child's vaccination status
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