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West Side School COVID-19 Public Health Complaint Form

Please complete the form as accurately and completely as possible. Describe each area of concern in as much detail as you can, including location at the worksite. If there is any evidence that supports your suspicion that a hazard exists (for instance, a recent accident or physical symptoms of employees at your site) include the information in your description.

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Your relationship to West Side School*
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COVID-19 Public Health Complaint*
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Has the superintendent/principal been notified about these concerns? *
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Has Public Health been notified about these concerns? *
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