JavaScript is disabled on your browser. Please enable JavaScript to use this site.
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:
Write-In Answer
Last Name:
Write-In Answer
Shepherd University Email:
Write-In Answer
Phone Number (cell phone preferred):
Write-In Answer
College Affiliation:
Student
Staff
Faculty
Guest
I am making this report of COVID-19 symptoms, testing, and/or exposure for:
Myself
Someone else (Full name of individual)
Write-In Answer
Other
Write-In Answer
Next