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Apply
Apply
Cadet Contact Tracing Form
What is your name?
(Required)
First
Last
Are you an athlete?
(Required)
Yes
No
Your Email Address
(Required)
What date did you become ill OR receive a positive test (whichever came first)?
(Required)
MM slash DD slash YYYY
Subtract 2 days from the date of illness/positive test. This is your contact tracing date; please enter it below.
(Required)
MM slash DD slash YYYY
How many ON-CAMPUS close contacts have you had since your contact tracing date? (Please see definition of "close contact" below)
(Required)
A "close contact" is anyone who has been closer than 6 ft. to you for a CUMULATIVE of 15 min. in a 24-hour period while unmasked since the contact tracing date you input above. (For example, if you were around someone unmasked and within 6 ft. for 5 minutes at breakfast, 5 minutes at lunch, and 5 minutes at dinner, they are a close contact).
None
5 or fewer
More than 5
Contacts 1-5 Information
Contact #1
(Required)
First
Last
Contact #1 Company
Alpha
Bravo
Charlie
Delta
Echo
Band
HQ
Contact #1 Phone Number
Last date of contact
(Required)
MM slash DD slash YYYY
Was Contact #1 masked?
(Required)
Yes
No
Were you masked?
(Required)
Yes
No
Were you closer than 6 ft. apart?
(Required)
Yes
No
Contact #2
First
Last
Contact #2 Company
Alpha
Bravo
Charlie
Delta
Echo
Band
HQ
Contact #2 Phone Number
Last date of contact
MM slash DD slash YYYY
Was Contact #2 masked?
Yes
No
Were you masked?
Yes
No
Were you closer than 6 ft. apart?
Yes
No
Contact #3
First
Last
Contact #3 Company
Alpha
Bravo
Charlie
Delta
Echo
Band
HQ
Contact #3 Phone Number
Last date of contact
MM slash DD slash YYYY
Was Contact #3 masked?
Yes
No
Were you masked?
Yes
No
Were you closer than 6 ft. apart?
Yes
No
Contact #4
First
Last
Contact #4 Company
Alpha
Bravo
Charlie
Delta
Echo
Band
HQ
Contact #4 Phone Number
Last date of contact
MM slash DD slash YYYY
Was Contact #4 masked?
Yes
No
Were you masked?
Yes
No
Were you closer than 6 ft. apart?
Yes
No
Contact #5
First
Last
Contact #5 Company
Alpha
Bravo
Charlie
Delta
Echo
Band
HQ
Contact #5 Phone Number
Last date of contact
MM slash DD slash YYYY
Was Contact #5 masked?
Yes
No
Were you masked?
Yes
No
Were you closer than 6 ft. apart?
Yes
No
Contacts 5+ Information
Please list any additional close contacts below.
Add
Remove
Do you verify that ALL of the additional people above meet the definition of a "close contact"? (Were within 6 ft. of you for longer than 3-4 minutes without masks since your contact tracing date?)
Yes
No
Other
