2020 MASL Fall Contact Tracing Form

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The purpose of this form is to help us keep track of any potential COVID exposure to league teams/players and referee crews. This information will be kept confidential and will ONLY be used for notifying those who are potentially at risk. This information will only be accessible by a limited number of league leadership who is designated to handling COVID related items.

Email *

First Name *

Last Name *

Phone Number *

Team Name *

Please select the option that applies to your situation: *

Diagnosed with COVID-19 (confirmed thru testing)

Showing COVID-19 symptoms (testing soon)

Have you or anyone in your household been tested for COVID-19 prior to now? (within last month) *

Yes

What was the date of the last test for yourself? (if applicable)

YYYY

Was the test positive or negative for COVID?

Positive for COVID

Negative for COVID

Clear selection

How many days have you been symptom free?

Date of Last Match You Played In MASL *

YYYY

Send me a copy of my responses.

Submit

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