COVID-19 Tracking Form

MEA is tracking confirmed COVID-19 incidents, from the start of returning to the office on September 13, 2021. We ask members to complete this form for each incident which you receive notice.

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* 1. Which agency are you with?

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* 2. Which date did you receive notification about the COVID-19 incident? (mm/dd/yy)

Date

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* 3. Were you notified the date of the COVID-19 incident, if so, which date? (mm/dd/yy)

Date

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* 4. Where was this incident?

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* 5. Were you provided with instructions to follow?

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* 6. What instruction(s) did you receive? If so, what were they?

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* 7. Were you provided with any additional information regarding the incident? If so, what were they?

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