By completing this form, you acknowledge that
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What is contained in it is accurate to the best of your ability
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I understand I will be contacted by an employee of SE to gain more information to assist us with appropriate care measures for you and illness tracking within our campus community
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We may use the information to notify your work supervisor and/or professors on the SE campus, in general terms, regarding the need to take a medical absence until such time it is deemed appropriate to return to campus safely.