COVID-19 Testing & Vaccination Submission Portal
Please select the event you are planning to attend
*
Please Select
Homecoming 2022
Fall 2022 Student Arrival Covid Test Results
COVID Vaccine/Booster Upload
COVID Exemption Request
Weekly COVID Testing
Open House
Campus Tour
Test Results must be dated within 3 days of arrival
Role
*
Please Select
Faculty/Staff
Hornet Ambassador
Student
Contractor
BOT
Visitor
University ID# (D100)
*
Please include the D
DSU Email Address
*
example@example.com
Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Have you been vaccinated?
Yes
No
Are you up to date with your booster shots
Yes
No
When did you receive your most recent dose of the Moderna/Pfizer booster
-
Month
-
Day
Year
Most Recent Booster Date
Are you submitting a Vaccination Card or Covid-19 Test Result
Vaccination Card
COVID-19 Test Result
PLEASE CONTACT CAMPUS HEALTH @ 302-857-6393
Upload a photo or copy of your COVID-19 Vaccination/Booster Card
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
COVID-19 Test Date
*
-
Month
-
Day
Year
COVID Test Date must be no more than 3 days prior to event date (except Weekly COVID Testing)
COVID-19 Test Result
*
Negative
Positive
Upload a photo or copy of your Negative COVID-19 Test Results
*
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Drag and drop files here
Choose a file
Cancel
of
Please upload your exemption request supporting documents
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of
Please verify that you are human
*
Signature
Submit
Reporting Date
-
Month
-
Day
Year
Date
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