Reporting a COVID Case or Exposure

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Your Name*

Date*

Email*

Phone Number*

Department*

Description of Incident**avoid using employee names

Is there potential for additional exposures?*

yes

no

If yes, please explain:

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Your Name*

Local Campus Address*

Phone Number*

I am affiliated with OSU as a/an*

Student

Employee

Faculty

Community Resident

CWIDcampuswide ID number

I am reporting:*

a positive test

an exposure

contact of a contact

for someone else

What type of test did you have?

PCR (Molecular)

Antigen

Other (please explain in comments)

When was your test?

What is the name and location of the testing facility?

Comments

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