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Report a COVID Symptomatic Student/Close Contact

This form will be used to notify the School Nurse when a student or someone they've come into close contact (within 6 feet for ≥ 15 minutes) is experiencing any COVID-19 related symptoms that cannot be attributed to an underlying condition and/or does not meet a student's health baseline.  Student privacy will be maintained at all times.  

Are you experiencing any of these symptoms?*
Answer Required
Yes
No
Fever above or equal to 100.4 degrees and/or chills
Shortness of breath/difficulty breathing
Cough
Fatigue
Muscle aches
Nausea, vomiting, and/or diarrhea
New loss of taste and/or smell
Congestion, sore throat, and/or runny nose
Headache
In the past 14 days, have you been exposed to someone with known or suspected COVID-19?*
Answer Required

If you answered YES to any of the above questions, please do not enter campus. You will be contacted by a staff member shortly.

Thank you for completing this Daily COVID-19 Survey.