{"id":12950,"date":"2020-11-02T22:55:54","date_gmt":"2020-11-02T21:55:54","guid":{"rendered":"https:\/\/www.mommsen.edu.it\/?page_id=12950"},"modified":"2022-02-13T15:53:40","modified_gmt":"2022-02-13T14:53:40","slug":"comunicazione-assenza-e-o-tampone-per-covid-19-secondaria-carroll","status":"publish","type":"page","link":"https:\/\/www.mommsen.edu.it\/old\/comunicazione-assenza-e-o-tampone-per-covid-19-secondaria-carroll\/","title":{"rendered":"Segnalazione alunno COVID-19 &#8211; Secondaria Carroll"},"content":{"rendered":"<p class=\"message\"><strong>Compila attentamente tutti i campi<\/strong> prima di premere il tasto invia.<br \/>\nLa comunicazione con i dati che hai inserito sar\u00e0 inviata tramite mail alla segreteria dell\u2019Istituto.<br \/>\nCome riscontro dell&#8217;invio del messaggio riceverai una mail all&#8217;indirizzo da te indicato nel modulo.<br \/>\n<span class=\"wpcf7-not-valid-tip\">Eventuali comunicazioni da parte dell&#8217;Amministrazione avverranno tramite posta elettronica.<\/span><\/p>\n<div class=\"box modulo\">\n<h3>Segnalazione alunno caso positivo \/ contatto stretto COVID-19 &#8211; Secondaria Carroll<\/h3>\n<p>Roma, 23.10.2026<\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f12951-o1\" lang=\"it-IT\" dir=\"ltr\" data-wpcf7-id=\"12951\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/old\/wp-json\/wp\/v2\/pages\/12950#wpcf7-f12951-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Modulo di contatto\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"12951\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"it_IT\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f12951-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7dtx_version\" value=\"5.0.7\" \/>\n<\/fieldset>\n<p><span class=\"wpcf7-not-valid-tip\">* <i>Campo obbligatorio<\/i><\/span>\n<\/p>\n<p class=\"dx\">Al Dirigente Scolastico dell'IC \"Via T. Mommsen, 20\"\n<\/p>\n<h4>Informazioni sul genitore\/tutore legale:\n<\/h4>\n<p>Nome del genitore\/tutore*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nome-genitore\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nome genitore\" value=\"\" type=\"text\" name=\"nome-genitore\" \/><\/span>\n<\/p>\n<p>Cognome del genitore\/tutore*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cognome-genitore\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Cognome genitore\" value=\"\" type=\"text\" name=\"cognome-genitore\" \/><\/span>\n<\/p>\n<p>E-mail e telefono*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email form-control1\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email\" value=\"\" type=\"email\" name=\"email\" \/><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"telefono\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control1\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Telefono\" value=\"\" type=\"text\" name=\"telefono\" \/><\/span>\n<\/p>\n<p>Copia documento genitore*:\n<\/p>\n<p><span class=\"small\">(caricare solo file in formato PDF o JPG - dimensione massima 3 Mb)<\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"documento\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"documento\" \/><\/span>\n<\/p>\n<h4>Informazioni sull'alunno\/a:\n<\/h4>\n<p>Nome*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nome-alunno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nome alunno\/a\" value=\"\" type=\"text\" name=\"nome-alunno\" \/><\/span>\n<\/p>\n<p>Cognome*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cognome-alunno\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Cognome alunno\/a\" value=\"\" type=\"text\" name=\"cognome-alunno\" \/><\/span>\n<\/p>\n<p>Codice fiscale*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cod-fiscale\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Codice fiscale\" value=\"\" type=\"text\" name=\"cod-fiscale\" \/><\/span>\n<\/p>\n<p>Classe e sezione*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"classe\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required form-control1\" aria-required=\"true\" aria-invalid=\"false\" name=\"classe\"><option value=\"\">&#8212;Seleziona un&#039;opzione&#8212;<\/option><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"sezione\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required form-control1\" aria-required=\"true\" aria-invalid=\"false\" name=\"sezione\"><option value=\"\">&#8212;Seleziona un&#039;opzione&#8212;<\/option><option value=\"G\">G<\/option><option value=\"I\">I<\/option><option value=\"L\">L<\/option><option value=\"M\">M<\/option><option value=\"N\">N<\/option><\/select><\/span>\n<\/p>\n<p>Tipo di segnalazione*\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tipo\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required form-control\" aria-required=\"true\" aria-invalid=\"false\" name=\"tipo\"><option value=\"\">&#8212;Seleziona un&#039;opzione&#8212;<\/option><option value=\"alunno positivo COVID-19\">alunno positivo COVID-19<\/option><option value=\"alunno contatto stretto COVID-19\">alunno contatto stretto COVID-19<\/option><\/select><\/span>\n<\/p>\n<p>Data primo giorno di assenza*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"data-ass\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control1\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"gg\/mm\/aaaa\" value=\"\" type=\"text\" name=\"data-ass\" \/><\/span>\n<\/p>\n<p>L\u2019alunno\/a ha presentato\/presenta sintomi*:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"sintomi\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required form-control1\" aria-required=\"true\" aria-invalid=\"false\" name=\"sintomi\"><option value=\"\">&#8212;Seleziona un&#039;opzione&#8212;<\/option><option value=\"S\u00ec\">S\u00ec<\/option><option value=\"No\">No<\/option><\/select><\/span>\n<\/p>\n<p>Data eventuale tampone dell'alunno\/a:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"data-tampone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text form-control1\" aria-invalid=\"false\" placeholder=\"gg\/mm\/aaaa\" value=\"\" type=\"text\" name=\"data-tampone\" \/><\/span>\n<\/p>\n<p>Esito esito eventuale tampone dell'alunno\/a:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"esito-tampone\"><select class=\"wpcf7-form-control wpcf7-select form-control1\" aria-invalid=\"false\" name=\"esito-tampone\"><option value=\"\">&#8212;Seleziona un&#039;opzione&#8212;<\/option><option value=\"Positivo\">Positivo<\/option><option value=\"Negativo\">Negativo<\/option><\/select><\/span>\n<\/p>\n<p>Consegna esito eventuale tampone dell'alunno\/a:\n<\/p>\n<p><span class=\"small\">(caricare solo file in formato PDF o JPG - dimensione massima 3 Mb)<\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"allegato\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".pdf,.jpg\" aria-invalid=\"false\" type=\"file\" name=\"allegato\" \/><\/span>\n<\/p>\n<h4>Autodichiarazioni*:\n<\/h4>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-11\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-11\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Tutte le dichiarazioni contenute nella presente modulo sono autocertificate dal\/dalla richiedente consapevole delle responsabilit\u00e0 penali, ai sensi e per gli effetti degli artt. 46, 47 e 76 del DPR 445\/2000. Il\/la richiedente DICHIARA di compilare il presente modulo in osservanza delle disposizioni sulla responsabilit\u00e0 genitoriale, di cui agli artt. 316, 337 ter e 337 quater del C. C., che richiedono il consenso di entrambi i genitori.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-14\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-14\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Il richiedente DICHIARA di aver letto l'Informativa Privacy all'indirizzo <a href=\"https:\/\/www.mommsen.edu.it\/il-sito\/privacy\/\">https:\/\/www.mommsen.edu.it\/il-sito\/privacy\/<\/a><\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p>&nbsp;\n<\/p>\n<p>P.S.: Ai sensi del DL n. 5\/2022, la riammissione a scuola avviene mediante esibizione dell\u2019esito negativo del test antigenico o molecolare (<b>senza certificazione medica<\/b>).\n<\/p>\n<h4>Inserisci i caratteri presenti nell'immagine*:\n<\/h4>\n<p><input type=\"hidden\" name=\"_wpcf7_captcha_challenge_captcha-882\" value=\"2408217877\" \/><img loading=\"lazy\" decoding=\"async\" class=\"wpcf7-form-control wpcf7-captchac wpcf7-captcha-captcha-882\" width=\"84\" height=\"28\" alt=\"captcha\" src=\"https:\/\/www.mommsen.edu.it\/old\/wp-content\/uploads\/wpcf7_captcha\/2408217877.png\" \/>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"captcha-882\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-captchar form-control1\" autocomplete=\"off\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"captcha-882\" \/><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner btn\" type=\"submit\" value=\"INVIA\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<p>&nbsp;<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Compila attentamente tutti i campi prima di premere il tasto invia. La comunicazione con i dati che hai inserito sar\u00e0 inviata tramite mail alla segreteria &#8230; <\/p>\n","protected":false},"author":49,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":"","_members_access_role":[],"_members_access_error":""},"tags":[],"class_list":["post-12950","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/pages\/12950","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/users\/49"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/comments?post=12950"}],"version-history":[{"count":4,"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/pages\/12950\/revisions"}],"predecessor-version":[{"id":19708,"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/pages\/12950\/revisions\/19708"}],"wp:attachment":[{"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/media?parent=12950"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mommsen.edu.it\/old\/wp-json\/wp\/v2\/tags?post=12950"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}