COVID-19 Positive Cases

As of December 1, 2020, we're no longer asking members to reporting using this form. Until further notice, please email Citygate Network Vice President Justin Boles (jboles@citygatenetwork.org) if your ministry has more than 10 new cases in a week to report. As always, Citygate Network is available for discussion and counsel as you navigate this pandemic.

Select the Tuesday Your Report Ends *

Report on Tuesday of Each Week for the 7 Previous Days

Organization Name *

Enter Organization Name if Not Represented Above

We'll add your organization name to the list

Citygate Network Member Status *

Member Non-member Unsure

Location *

City State/Province (eg, CA, TX)

Country

Email Address of Person Supplying Information (used to provide you with a record of your submission) *

example@example.com

Number of guests/clients newly infected with COVID-19 for this time period *

Enter a numeric value 0-999 for only NEW cases since last report

Number of guests/clients who died from COVID-19 complications for this time period *

Enter a numeric value 0-999 for only NEW cases since last report

Number of staff members/volunteers newly infected with COVID-19 for this time period *

Enter a numeric value 0-999 for only NEW cases since last report

Number of staff members/volunteers who died from COVID-19 complications for this time period *

Enter a numeric value 0-999 for only NEW cases since last report

SBA loan programs status (check all that apply for this reporting period)

Applied for Paycheck Protection Program (PPP) Applied for Economic Injury Disaster Loan (EIDL) Application for PPP and/or EIDL rejected Application for PPP and/or EIDL approved Funds for PPP and/or EIDL received

What, if anything, are your greatest needs this week? Examples might be disposable face masks, gloves, sanitation supplies, testing kits, additional space, additional staff, funds, etc.

My Organization's New COVID-19 Positive Cases