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Coronavirus (COVID19) Illness Reporting Form

Please complete this webform if you have been diagnosed with, exposed to, or in contact with someone who has been exposed to COVID-19. All responses will remain confidential and will only be visible to SCTE Event Management.

If you have been exposed or diagnosed, you must refrain from participating in any CLC activities for remainder of event.

What symptoms have you experienced? *
Have you been tested for COVID-19? *
If yes, Positive/Negative? *
Sought medical care? *

Thank you for reporting and take care!