Form 2: Positive COVID Test Report Form
MN River Youth Hockey is required to report lab-confirmed positive COVID cases of players, coaches and volunteers within our association. In order to communicate more efficiently with the MDH please complete the information below and a COVID Manager will be in contact with you as soon as possible. Information is kept private and only required information is reported to the MDH, coaches and team coordinators as needed for hockey operations.
* Required
Positive COVID case is a:
*
Player
Coach
Volunteer
Other
Required
First Name
*
Your answer
Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Team/Level
*
Your answer
Date last at practice or game:
*
MM
/
DD
/
YYYY
Date of COVID test collection:
*
MM
/
DD
/
YYYY
Symptoms, if any:
*
Your answer
Date of symptom onset, if applicable:
Your answer
Parent email:
*
Your answer
Additional Comments:
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of BulldogHockey.org.
Report Abuse
Forms
