(page 1/6)

You will need to hit "submit" on all 6 pages to receive your confirmation email

Submit moves you to the next form automatically.

  • Educational sites are required to notify Public Health of all cases of laboratory-confirmed COVID-19 among employees, students, and children that were on site at any point within 14 days prior to becoming ill. Notification should occur in 1 business day for 1-2 cases and immediately for 3 or more cases.
  • The illness onset date is the first date of COVID-19 symptoms. If the case had no symptoms, the illness onset date is the COVID-19 test date.
  • Persons with COVID-19 who were not on site during this time frame are not required to be reported by the site, unless reporting a death of an individual who had COVID-19 illness and was affiliated with the site.
  • If you are reporting 2 or more cases within 14 days of each other, please submit one line list for these cases and their contacts on site.
  • If you are notifying DPH of an UPDATE to a prior report, please update the original report with the new information - you can access the original report by using the unique return link provided to you when you submitted your report.
Loading... Loading...
The option "" can only be selected by itself. Selecting this option will clear your previous selections for this checkbox field. Are you sure?
You have selected an option that triggers this survey to end right now. To save your responses and end the survey, click the button below to do so. If you have selected the wrong option by accident and do not wish to leave the survey, you may click the other button below to continue, which will also remove the value of the option you just selected to allow you to enter it again and continue the survey.
The response has now been removed for the last question for which you selected a value. You may now enter a new response for that question and continue the survey.