EmailMeForm
Ohio North COVID-19 Positive Test Notification
This form should only be used to report a positive COVID-19 test for a player or coach. If a player or coach tests positive
ALL TEAM ACTIVITIES ARE SUSPENDED IMMEDIATELY.
All members of the team will impose a 14-day self quarantine as directed by the CDC, Ohio Department of health, and the Ohio North Youth Soccer Association.
Individual Completing the Form.
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First
Last
Individual's Email
*
Confirm Email
Individual's Phone
*
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Club Information
Club associated with the COVID-19 positive result.
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Club's Primary Point of Contact.
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First
Last
Club President or Registrar
Club's Primary Point of Contact email address.
*
Confirm Email
Has the club's Primary Point of Contact been notified?
*
Please select
Yes
No
What league(s) do you participate in?
*
Great Lakes Conference
OSSL
Northern Conference
GAASA
YAYSL
Rec/In-House
Other
Name of the team(s) that the individual with a positive result plays/coaches on.
*
If the player/coach participated on or with multiple teams prior to testing positive please list all teams they associated with while potentially positive for COVID-19.
Age group(s) the individual with a positive result plays/coaches on.
*
Additional Information
The individual that tested positive is a:
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Player
Team Official/Coach
Referee
Other
Does the individual with a positive result participate on other team(s)?
*
Please select
Yes
No
If yes, please provide the additional club and team information below.
When did the individual with a positive result begin experiencing symptoms?
*
MM
/
DD
/
YYYY
What date was the positive test result received/confirmed?
*
MM
/
DD
/
YYYY
