Employee Reporting of Coronavirus (COVID-19) Illness or Potential Exposure
To be filled out and submitted by affected Employee (or their supervisor, if the employee is unable to submit). Employees shall notify their supervisors of any work-related illness or exposure.
Sign in to Google to save your progress. Learn more
Clear form
Never submit passwords through Google Forms.
This form was created inside of National Oceanic and Atmospheric Administration. Report Abuse