BMCC COVID SAFETY FORM **This information is used for tracking COVID cases at BMCC and for reporting and sanitizing purposes only.

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COVID FORM

**Disclaimer**

This information is used for tracking campus COVID cases and for reporting and sanitizing purposes only.

Thank you,

Blue Mountain Community College

Questions: Caitlin Steele csteele@bluecc.edu

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I have: (choose ONE)

Tested positive for COVID in the last 24hrs

A known exposure to someone who tested positive for COVID in the last 24hrs

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I am a: (choose ONE)

Student

Faculty/Adjunct

Staff

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Please indicate, specifically, what building you spent the most time in the last 24hrs: (Columbia Hall, Morrow Hall, Pioneer Hall, etc.)

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Please *also* tell us what ROOMS you were in the last 24hrs: (M208, P120)