If you have been in contact with someone who has tested positive for COVID-19 and would like to self-report, please complete the COVID Exposure Questionnaire below to receive a verficatoin letter of your self reported exposure.  According to the Center for Disease Control a close contact is considered someone that has been within 6 feet of a COVID positive individual for 15 minutes or more throughout the course of a day. If you are fully vaccinated (including a booster dose at least 5 months following primary series, if eligible) you do NOT need to quarantine per CDC recommendations, but you do need to monitor for symptoms and wear a mask in public for a full 10 days following exposure.

If you are not fully vaccinated (including eligible booster dose) and have been in close contact to an individual with COVID-19, the CDC recommends you stay at home for a full 5 days and wear a well-fitted mask if you must be around others in your home. If asymptomatic after day 5, you may resume normal activities while wearing a mask in public and around others for a remaining 5 days. Continue to monitor for symptoms for a full 10 days following exposure. If symptoms develop, isolate from others and get tested for COVID-19. It is recommended to avoid travel or be around high-risk individuals during your quarantine period.

If you have questions, please contact TCHD at 417-334-4544 ext 577. 


1. First Name *

2. Last Name *

3. Date of Birth (Month/Date/Year) *

4. Email Address Where Documents Can be Sent if Needed *

5. Physical Address *

6. Who was the COVID-19 positive individual you were in close contact with? *

7. Date of Exposure (Month/Date/Year) *

8. Do you have any COVID-19 symptoms? *

9. If yes, please list symptoms.

10. Phone Number *