Thank you for reporting your positive rapid antigen test.
If you are a parent, legal guardian or authorised carer, you can fill in this form for your child or someone you care for.
If you are a health professional, you can complete the online form on behalf of your patient or client.
Answering these questions will help keep you and your community safe. Please answer honestly and completely so we can make sure you get the right support.
Your personal information is kept safe and is protected by legislation. Information is only shared where needed to protect public health. For more information visit
https://www.coronavirus.vic.gov.au/privacy-vicgovau
If you need to talk to someone about this survey in another language, please call 1800 675 398 (press 0 for an interpreter).