COVID-19 Suspected Outbreak Form

Questions marked with a * are required
This portal is for reporting of a suspected outbreak by business owners/managers, administrators and supervisors for facilities in Calaveras County. Please be sure to provide as much information as possible. A separate report needs to be submitted for each facility/site with  COVID-19 cases.
Facility/Site Information
Facility/Site Name:
Facility/Site Street Address:
Facility/Site City:
Facility/Site Zip Code:
Facility/Site Phone Number:
Point of Contact Information
Point of Contact Information
Additional Information
What type of facility/site are you reporting for? Please review all categories and choose the best fit.
Additional Information: