COVID-19 Contact/Exposure Report Form

Contact Information

This form is for individuals to notify Shepherd University of incidents related to COVID-19 or to self-identify as affected by COVID-19. 

The information is confidential. 

First Name:
Last Name:
Shepherd University Email:
Phone Number (cell phone preferred):
College Affiliation:
I am making this report of COVID-19 symptoms, testing, and/or exposure for: