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Report a Positive Home COVID-19 Test

  1. If you are a North Attleboro resident and have tested positive for COVID-19 using a home test kit, please submit the following form to the North Attleboro Health Department. Each positive person in the household needs to be reported. If you need to submit more than three people, please submit a second form.

  2. Return Call / Email*
  3. Date of First Positive Test

  4. Symptoms*

    Is this individual experiencing any COVID-19 symptoms?

  5. Contact with a Positive Case*

    Has this individual had contact in the last 10 days with an individual who has tested positive for COVID-19?

  6. Date of First Positive Test

  7. Symptoms

    Is this individual experiencing any COVID-19 symptoms?

  8. Contact with a Positive Case

    Has this individual had contact in the last 10 days with an individual who has tested positive for COVID-19?

  9. Date of First Positive Test

  10. Symptoms

    Is this individual experiencing any COVID-19 symptoms?

  11. Contact with a Positive Case

    Has this individual had contact in the last 10 days with an individual who has tested positive for COVID-19?

  12. Leave This Blank:

  13. This field is not part of the form submission.