COVID-19 • Site Reporting
Please complete one form for each unit or employee that you are reporting.
Total Number of Tenants in Development
COVID-19 Event Information
Choose the type of report.
Number of Site Staff Affected
Indicate the number of staff members affected
Number of Site Staff Hospitalized
Indicate the number of site staff hospitalized
Select the appropriate event type for the unit or employee you're reporting on. Please select one.
# of HH members
Enter the number of household members residing in the unit.
Date Management Learned of COVID-19 event
When did you learn of this specific event?
Number of Residents Hospitalized
How many residents in the unit are hospitalized?
Your name here please.
Steps to Control the Spread
Please attach 1.) Notice to the residents informing the community of the confirmed case; 2.) Management's response to prevent the spread of the virus.
Send me a copy of my responses
Your submission is being processed. Please do not close this browser window until complete.