Information collected from this report will be used as a part of our COVID-19 mitigation response. COVID-19 is a reportable disease in Minnesota. Institutions of higher education are required to report cases and deaths to MDH, per Minnesota Rules, part 4605.7070 (www.revisor.mn.gov/rules/4605.7070/). Any employee who is made aware of a student who has tested positive for COVID-19 or has had a recent exposure to COVID-19 is required to report this information to the university through this form.
Students: Use this form to voluntarily report to the university an exposure to, assumed case, or diagnosis of COVID-19. This form will be routed to the Pandemic Team. A member of the team will notify your faculty instructor(s) and advisor.
Employees: The university needs to maintain a safe/clean working environment for all employees who must remain working on campus. Given these extraordinary circumstances, we are asking for your help to keep the campus clean and employees safe. Employees are strenuously encouraged to report exposures to COVID-19 using the form on the university website. The completed forms will be routed to Human Resources to use the information for notifying campus operations on what areas need to be cleaned, to notify individuals who may have come in contact with the affected individual, and to provide resources to employees.
This is not a diagnostic tool. If you are experiencing coronavirus (COVID-19) symptoms, contact your primary care provider. If you are experiencing a medical emergency, call 9-1-1.