Form 1: COVID Exposure/Symptoms/Awaiting COVID Test Results
Planning ahead helps prepare needed information in case we need to make notifications to teams and families. It also helps us get responses from the MDH faster when we have all the information we need (if reporting is necessary). If a player/coach/volunteer/family member has COVID symptoms or is awaiting test results please complete the information below. Please email
covidmanager@bulldoghockey.org
with any questions.
* Required
Person with COVID exposure/symptoms/awaiting test results:
Player
Coach
Volunteer
Family member
Other:
Name of person this report pertains to:
*
Your answer
Team Name/Level:
*
Your answer
Symptoms and date of onset (if applicable):
Your answer
Date of exposure, if applicable:
MM
/
DD
/
YYYY
Date last at practice/game:
*
Your answer
Date COVID test collected, if applicable:
Your answer
Parent email:
*
Your answer
Additional Comments:
Your answer
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