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COVID-19 Reporting

Please complete the form below. Required fields marked with an asterisk *
Contact Information
Vaccination Status*
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Close Contact

Close contact is defined as being within 6 feet of another individual for 15 minutes or more over a 24-hour period with or without masks.

Have you had COVID-19 in the last 90 days?*
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Do you have a confirmed positive test?*
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Are you experiencing symptoms?*
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