undefined

Covid 19 Contact Tracing Form

Template for Contact Tracing will help track down people who are in danger of being exposed to the virus.

1 minute to complete

Eligibility

Only individuals who have been in close contact with a confirmed case of Covid 19 are eligible to fill out the contact tracing form.

undefined

Questions for Covid 19 Contact Tracing Form

Questions

1.

Date:

The answer should be a date input.
2.

Contact:

The answer should be a text input.
3.

Symptoms:

The answer should be a text input.
4.

Location of the incident:

The answer should be a text input.
5.

Additional information about the contact.

The answer should be a text input.

Forms Similar to Covid 19 Contact Tracing Form

  • Covid 19 Exposure Form
  • Covid 19 Contact Form
  • Covid 19 Screening Form

Here are some FAQs and additional information
on
Covid 19 Contact Tracing Form

Who is considered the closest contact for a COVID-19 patient?

Within 2 meters of a person infected with COVID-19 for an extended period of time is considered close contact. Living with, visiting, or sharing a closed space with the infected person falls under this category. Being coughed upon by a person with COVID-9 infection qualifies you as a close contact.

How long does the virus cause COVID-19 to last on the surface?

Researchers evaluated the survival of the COVID-19 virus on different surfaces and reported that the virus can remain viable for up to 72 hours on plastic and stainless steel, up to four hours on copper, and up to 24 hours on cardboard.

How come contact tracing helps in reducing the spread of COVID-19?

You will be sent the link to the contact tracing form, where you need to provide the contacts of people who have been in contact with you for 72 hours. They will be contacted and quarantined for a specific period. This helps in breaking the chain of spread.

What if my results came Positive?

Getting a positive result can be nerve-wracking but don't panic. Coronavirus is generally curable. To prevent the spread of the disease, you stay quarantined while taking medications for recovery and recall where you went and who you were in contact with recently.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Covid 19 Contact Tracing Form

1000+ Templates, 50+ Categories

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE