Editing previous response:

Please fix the highlighted areas below before submitting.

COVID-19 Reporting

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

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?*
Answer Required
Do you have a confirmed positive test?*
Answer Required
Are you experiencing symptoms?*
Answer Required
Confirmation Email