COVID-19 Illness Notification

Use this form to report release of individuals from jobsite due to COVID-19 exposure or illness, listing the symptoms below. There is a printable version of the form also available below.

Documents

PDF icon COVID-19 Illness Notification (102 KB)
Date Released from Work

Workers may return to work consistent with CDC guidelines: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html

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