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School-Based COVID-19 Testing Program Development Survey

The Wisconsin Department of Health Services (DHS) has received funding from the Centers for Disease Control and Prevention (CDC) to develop a program to support school-based COVID-19 testing for teachers, staff and students. Testing can help detect new cases to prevent outbreaks, reduce the risk of further transmission, and protect the school community from COVID-19.

This one-page survey is intended to inform the development of a statewide testing program best suited to the needs of schools in Wisconsin and assess your interest in various types of testing programs. Answers to this survey are nonbinding and will not be treated as an official commitment to participate in this program.

For more information about COVID-19 testing in school settings to help inform your answers to the questions below, please refer to: Please complete this survey by Friday, April 16, at 12 noon. If you have any questions about this survey, please contact Cassie Frankel.
1. What is the county name, district name (use school name if a private school), and school name? If completing this form for all of the schools in a district, please use [Districtwide] as the school name.

Note: If your school is not listed, please contact DHSK12COVIDTESTING@dhs.wisconsin.gov. *This question is required.
4. Are you currently conducting any form of COVID-19 testing in your school?
5. Which of the following models best describes your current COVID-19 testing program? Check all that apply.
  • * This question is required.
5. How satisfied are you with your current testing vendor or partnership?
Very DissatisfiedDissatisfiedNeutralSatisfiedVery Satisfied
5. Do you have a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver?
6. Are you interested in acquiring a CLIA Certificate of Waiver?
6. Are you interested in participating in a COVID-19 testing program funded by the State of Wisconsin?
Not at all interestedSomewhat disinterestedNeutralSomewhat interestedVery interested
7. Which of the following testing models would you be interested in pursuing? Check all that apply.
  • * This question is required.
8. When might you be interested in providing COVID-19 testing? Check all that apply.