GSNYPENN COVID Incident Report

GSNYPENN COVID-19 Incident Report
When an attendee at a Girl Scout event tests positive for COVID-19 after attending or within five days of participating in a Girl Scout in-person gathering, please send the template email (or a modified version) that is located below to any participant families. Please note that we do not want to share the personal information of the individual who tests positive to maintain their privacy.

If a COVID notice is sent to families after a Girl Scout event, please complete this COVID incident report.

Troop Leaders do not need to notify council staff if a member tests positive after a troop meeting.

If you need IMMEDIATE guidance, contact the GSNYPENN Emergency Line at 1.855.213.8555, option 4:
- Identify who you are
- Explain the nature of the emergency: positive COVID-19 test
- Provide a contact number for yourself and we will call you back immediately
Incident Response Lead is Christina Verratti, Director of Membership Support, at 315.915.8976 office, cverratti@gsnypenn.org or 315.915.8976 cell.

Refer any and all media inquiries to GSNYPENN. Media must be referred to Jaime Alvarez, Senior Director of Marketing & Communications, at 315.275.2251 office, 315.275.3152 cell or jalvarez@gsnypenn.org.
Date of this report:*

MonthDay Year
Date
Name of affected person involved:*

First Name Last Name
Age:*
Address:*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone:*

Area Code Phone Number
Name of parent/guardian, if minor:

First Name Last Name
Girl Scout member?*

YesNo
Troop # if applicable:*
Date of Contact:*

MonthDay Year
Date
Date of COVID-19 test:*

MonthDay Year
Date
Date Positive Test Confirmed:*

MonthDay Year
Date
Did the contact occur at:*

MeetingTrip/EventCampingDay Camp
Location of contact:*
Attach Attendee Log related to contact:

Browse Files

Cancelof
Others involved:*
Date Girl Scout council was notified:*

MonthDay Year
Description of possible contact:*
Were parents of minors notified?*
Who was contacted and what was their response?*
Was first aid provided?*

YesNo
Was assistance called (police or ambulance)?*

YesNo
Any other information applicable - such as hygiene and sanitation steps at the meeting to reduce contact; care given; etc:*
Name of Witness:

First Name Last Name
Phone Number of Witness:

Area Code Phone Number
Address of Witness:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name of Witness #2:

First Name Last Name
Phone Number of Witness #2:

Area Code Phone Number
Reported by:*

First Name Last Name
Phone Number*

Area Code Phone Number
Email
example@example.com
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Sample Messaging for Communicating a Potential COVID Contact.

Please note, we do not want to share the personal information of the individual who tests positive to maintain their privacy.

Dear Girl Scout Families,

We have been notified that a participant at our last Girl Scout event has tested positive for COVID. At this time, it is recommended that troop members wear a mask to any Girl Scout gathering that takes place within the next ten (10) days. Please follow the COVID guidelines put forth by the other organizations your child participates in (i.e. school, sports, church, etc.).

If you have any questions on GSNYPENN’s COVID policy, please contact info@gsnypenn.org.

Contact info@gsnypenn.org for support with questions and concerns.
Should be Empty:

GSNYPENN COVID-19 Incident Report