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COVID Reporting Form

COVID Reporting Form

This self-reporting form is used to notify the College if you have tested positive for COVID-19, are experiencing symptoms of COVID-19, have been in close contact with an individual who tested positive for COVID-19, and/or reside with an individual who tested positive for COVID-19.

Jefferson College will take every effort to protect personally identifiable information and will not disclose your identity or the identity of anyone with a coronavirus diagnosis unless disclosure to safety and first aid personnel is required for emergency treatment or is otherwise required by law. The College may be required to report details from the form to public health authorities and other governmental agencies.

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