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COVID-19 Notification Form


Students who test positive for COVID-19 or are made aware that they have been exposed to COVID-19 are recommended to report this information using the Student COVID-19 Notification Form.

If you are submitting documentation of vaccination or a previous positive test, please select Vaccine Documentation.

THis is the form where you request on-campus isolation housing.


This information will be made available only to Student Life and Health Services.

Background Information

 
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Email address must be of a valid format.
This field is required.
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When were you exposed or when did symptoms first start? Or date of test.
This field is required.
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This is YOU. Enter your Information here as well as above.
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Write N/A if you live off-campus

Involved Parties

Involved party 1

Questions

Why are you filling out this report?(Required)
You must make at least one selection.
What symptoms are you experiencing?(Required)
You must make at least one selection.
This field is required.
This field is required.
Isolation housing is extremely limited. Are you interested in isolation housing on campus?(Required)
This field is required.
Have you been fully vaccinated or do you have antibodies from a previous positive test from the last 90 days (not your current infection)? If so, please attach your documentation below (vaccine card with your name and date or your positive test results with your name and date).(Required)
This field is required.

Supporting Documentation

If you have a positive COVID-19 test result from somewhere outside LETU, please upload a copy of it here. Please include any doctor notes, discharge orders, school excuses, or other relevant documents. Please attach vaccine documentation here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission