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REPORT A COVID CASE OR CASES ASSOCIATED WITH YOUR BUSINESS OR ORGANIZATION

IMPORTANT:

  • Due to high volume of cases at this time, KPHD staff may not be able to contact you for several days. All information submited in this form will be added to our database. Please note that we prioritize return calls to congregate living settings including long term care, health care, and organizations with 2 or more lab-confirmed cases.
  • Do not report indiviual names or other personally identifying information in this form.
  • For guidance documents and other resources, visit our COVID page for businesses and organizations.

YOUR CONFIDENTIALITY


We will use your contact information to follow up on the report. If the information you provide is incorrect or incomplete, we may not be able to respond. A more detailed explanation of confidentiality is provided at the bottom of this page. Please do NOT include patient name or patient contact information.


Name:
E-mail:
Phone:
Business or Organization Name:
Number of confirmed cases:
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Thank you. We value your time.

 

DETAILS REGARDING REQUESTS FOR CONFIDENTIALITY

We want you to know that your identity and personally indentifying information are not automatically protected. For the purposes of a public records request, your identity and personally identifying information will be provided to anyone upon request unless these conditions are met:

  • You are reporting a potential Health District regulatory or enforcement violation; and
  • You specifically request confidentiality; and
  • Your confidentiality is protected under Washington State law (RCW 42.56).

Even if you request confidentiality and your identity is protected in a public records request, we may be required to disclose your identity in response to a subpoena, court order, or other compulsory legal process.


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