Salt Lake County

COVID-19 Home Test Reporting Form

Please use this survey to report your positive home COVID-19 test results.


The health department is not performing any contact tracing or follow-up on individual cases at this time. Information obtained through this portal may be used to identify possible outbreaks, inform surveillance, and guide response efforts.

 

Positive Patient Information

 
 
 
 
mm/dd/yyyy
 
Phone
 
 
 
 
 
 
 
 

Clinical Information

 
 
mm/dd/yyyy
 
 

High-Risk Setting Information