LNGBA Covid Reporting Form
Use this form to report a Positive Test or Quarantine. Individual privacy will be maintained, but LNGBA is required to report exposure to MDH, ISD194, and MYAS (without personally identifying information)
My Daughter's Name *
Parent/Guardian Name(s) *
Parent/Guardian email/phone *
My daughter has: *
Date of positive test (if applicable)
MM
/
DD
/
YYYY
Date of Exposure (if applicable)
MM
/
DD
/
YYYY
Is there reason to believe that the exposure was part of a basketball event? *
If YES or MAYBE above, where and when do you believe the exposure occurred
I have notified the school *
Submit
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