CTC COVID-19 Illness/Exposure Report Form
This form must be completed if you, or someone in your household, has had contact with CTC and:

1) Has tested positive for COVID-19, and/or;

2) Is exhibiting symptoms potentially consistent with COVID-19 (cough, shortness of breath, difficulty breathing, fever, chills, muscle aches, headache sore throat, diarrhea, or change in sense of smell and/or taste), and/or;

3) Has been exposed to someone who has tested positive for COVID-19 or who is exhibiting symptoms potentially consistent with the virus.

The affected individual should be tested for COVID-19 if possible, based upon local availability and capacity. Per local and state guidelines, CTC must inform those who were exposed to the individual.

CTC staff will maintain confidentiality according to applicable federal, state, and local health and safety standards except in the case of emergency.

Please visit CTC’s website for more detail about COVID-19 related practices and procedures, including when you may come back to work/class: commonwealththeatre.org/covid19

Please see the Team Kentucky webpage for additional information, including information on testing sites and laboratories performing testing for Kentuckian: govstatus.egov.com/kycovid19

Be well! We will get through this together.
Email *
Never submit passwords through Google Forms.
This form was created inside of Commonwealth Theatre Center. Report Abuse