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Elmira City School District MODERATE/SEVERE COVID-19 Return to Play Form (Return this medical form to the Health Office)If a student has tested positive and experienced a Moderate to Severe Case (See
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Consult with your healthcare provider to determine if you are eligible for a moderatesevere covid-19 return to form.
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Individuals who have been diagnosed with moderate to severe cases of covid-19 and are looking to return to work or other daily activities may need a moderatesevere covid-19 return to form.
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Moderate/severe COVID-19 return is the medical form individuals must complete to report their findings after contracting moderate to severe cases of COVID-19.
Individuals who have been diagnosed with moderate to severe cases of COVID-19 are required to file the return.
The form must be completed with accurate information about the individual's medical condition, symptoms, date of diagnosis, treatment received, and any complications experienced.
The purpose of the return is to track and monitor cases of moderate to severe COVID-19, assess the impact on individuals, and improve treatment strategies.
Information such as the individual's medical history, symptoms, treatment received, complications, and any other relevant details must be reported.
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