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Appendix C: Investigating COVID-19 Cases All personal identifying information of COVID-19 cases or symptoms will be kept confidential. All COVID-19 testing or related medical services provided by us will be provided in a manner that ensures the confidentiality of employees, with the exception of unredacted information on COVID-19 cases that will be provided immediately upon request to the local health department, CDPH, Cal/OSHA, the National Institute for Occupational Safety and Health (NIOSH), or as otherwise required by law. All employees' medical records will also be kept confidential and not disclosed or reported without the employee's express written consent to any person within or outside the workplace, with the following exceptions: (1) Unredacted medical records provided to the local health department, CDPH, Cal/OSHA, NIOSH, or as otherwise required by law immediately upon request; and (2) Records that do not contain individually identifiable medical information or from which individually identifiable medical information has been removed. Date: Name of person conducting the investigation: Occupation (if non- Employee (or non- employee, why they non- employee*) name: were in the workplace): Location where employee worked (or Date investigation was non-employee was initiated: present in the workplace): Was COVID-19 test Name(s) of staff offered? involved in the investigation: Date and time the Date of the positive or COVID-19 case was negative test and/or last present in the workplace; diagnosis: Information received Date the case first had regarding COVID-19 one or more COVID-19 test results and onset symptoms: of symptoms (attach documentation): Results of the evaluation of the COVID-19 case and all locations at the workplace that may have been visited by the COVID-19 case during the high-risk exposure period, and who may have been exposed (attach additional information):