Request Attendance Data

This form must only be completed by an official club representative if a Queensland Government or Queensland Health official has requested access to attendance data at your club/venue, or if there is a confirmed COVID case or link to a positive case at your club/venue.

Please do not complete this form to register a general enquiry regarding attendance data. More information on attendance data enquiries is available here.

Name*

First NameLast Name

Club or Venue*

Role at club/venue*

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

At the request of a Queensland Government official (must provide contact information of QLD Government official requesting data in question below)At the request of a Queensland Health official (must provide contact information of QLD Health official requesting data in question below)Due to a confirmed COVID case at club/venueDue to a confirmed COVID case with potential links to club/venue

Name and contact information of Queensland Government/Queensland Health official requesting attendance data*

Please complete the questions below if you are requesting access to the attendance data due to a confirmed COVID case at your club/venue, or a confirmed COVID case with potential links to your your club/venue.

When were you made aware of a positive COVID case at or linked to your club/venue? Please provide details of this.

When has this person visited your club/venue that you are aware of in the last 14 days? E.g. each Tuesday and Thursday night for training sessions etc.

What action has the club/venue taken since finding out about the COVID case or its possible link to the club/venue?

Any other additional information?