COVID-19 Incident Report

 

Use this form to notify GSBDC if anyone connected to your troop or service unit is diagnosed with Covid-19, and has potentially exposed others during a Girl Scout event or activity.
 

Tell Us about the person who was diagnosed with COVID-19:

 
 
 
 
 
 
 
 
 
 
 
 
 

Tell us about the gathering where they may have exposed others:

 
 
 
 
 
 
 
 
 
 
 
 
 

List all event attendees.

 
 
 
 
 
 
 
 
 

Tell us about yourself?