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Contact tracing form—potential contacts

Required fields are marked with an asterisk (*).
Personal details
(mobile preferred)
(e.g. your home/office contact number)
Date of Birth *
Are you currently in Queensland?
Please select all symptoms you are currently experiencing? *
Location visited

Privacy notice

Personal information collected by Queensland Health is handled in accordance with the Information Privacy Act 2009. Queensland Health is collecting information in relation to your personal details in order to assist us with COVID-19 contact tracing.

The personal information provided by you will be securely stored and made available only to appropriately authorised officers of the Department of Health or Hospital and Health Services.

Your personal information will not be disclosed to other third parties without consent, unless required by law. For information about how the Department of Health protects your personal information, or to learn about your right to access your own personal information, please see Queensland Health’s privacy statement

Last updated: 21 July 2021