Presbyterian Church of Wyoming Covid-19 Contact Tracing Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If someone at any meeting on church property tests positive for COVID-19, the county health department may initiate contact tracing. In order for the church to assist, please agree to the following by fill in out the form and signing below.

• I give the Presbyterian Church of Wyoming permission to share my contact information for contact
tracing purposes.

• If I should test positive for COVID within two weeks of any meeting on PCW property, I will inform the group chair or convener.

• If I should test positive for COVID within two weeks of any meeting on PCW property, I will ask the contact tracer if other members of my group or committee need to be contacted.

Email Address *

Phone Number *

Date *

YYYY

Signature *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms