AFL Covid incident report
COVID officers name
Your answer
Club name
Your answer
Contact email
Your answer
Contact number
Your answer
Type of incident
Club member diagnosed
Other Covid related problem
Clear selection
On what date did the diagnosis/concern occur?
MM
/
DD
/
YYYY
How many individuals have tested positive?
Your answer
How was the individual confirmed as positive
Testing
Asked to isolate - Contacted by track and trace
Other:
Clear selection
How many club sessions did the individual(s) attend within 48hrs of the confirmed positive test
Your answer
How many games did the individual attend within 48hrs of their result?
Your answer
How many players and support staff have potentially been in physical contact with the individual
Your answer
Have you commenced contact tracing with those who had close contact with the individual?
Yes
No
Clear selection
Have you informed the impacted individual(s) of the need to follow government guidelines and/or isolate?
Yes
No
Clear selection
Please confirm the level of activity the individual who tested positive had been involved in
Small group activity - social distanced
Large group activity - social distanced
Medium risk activity touch/tag
Other:
Clear selection
is there any more information you would like to provide relating to the handling of this incident at your club?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
