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COVID-19 Documentation for Early Years and ES

Dear Families,
Please complete this brief form for each student. Per government guidelines, WBAIS needs accurate, updated information about your child/children's vaccination status and/or recovery status.

This form requires the dates of vaccination/recovery as well as uploading these documents. When you have this information ready, the form is expected to take 1-2 minutes to complete.

The information is being collected to ensure your health and safety, the health and safety of the community, and to be in compliance with guidelines.

Thank you for your cooperation and your time!


First Name (student)

Last Name (student)


Has this student recovered from Covid-19? If yes, enter the date on the certificate of recovery

If no, please continue to next question.

How many vaccine doses has this student received?

Date of most recent vaccination dose

If this vaccination was not in Israel, please provide details of the type and date of all vaccinations