This HIPAA-compliant form should be completed by the person who has tested positive, is experiencing symptoms, or has been exposed to someone with Covid-19.
Only in circumstances where the person cannot report themselves should another person use this form to report on behalf of an employee or student. The person should be aware you are making this report.
If you are completing this report after 4:30pm on Friday you will be contacted the next business day. Please wear a mask and stay home/in your room until you have been contacted.