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Contagious Disease Control Protocol

Notification of Travel

Notification of Symptoms or Positive for Covid-19

Notification of Risk of Exposure

Please use this form to notify WTA, if you think you might have been exposed to Covid-19.

DO NOT visit the Gwun until you have been notified by the WTA and cleared to attend training.

Thank you for doing your part to keep your fellow members and training partners safe.

*
Preferred Name Surname
Date of Risk of Exposure*
Enter the date that you might been exposed to the Covid-19

Day
Month
Year
Type of Exposure*
- Contact with a Confirmed Case (High Risk Case)
- Contact with a High Risk Case (Possible-Case)
- Contact with a Possible-Case (2nd-Level-Possible-Case)
- You or a household member visited a location of interest at the time and date published online
- Household member has symptoms
- Household member has travelled outside of the Wellington region