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MS COVID-19 Documentation: Action Required

Dear Middle School Families,
Please complete this brief form for each Middle School student. Per government guidelines, WBAIS needs accurate, updated information about your child/children's vaccination record 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!

Email

First Name (student)

Last Name (student)

Grade

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