COVID-19 (coronavirus) self-monitoring form

In an effort to care for all members of our community during the rapid national and international transmission of the COVD-19 virus, it is imperative that we receive information about recent travel of members of our campus community.

Faculty and staff who have been traveling in the last 14 days, and all students who are requesting to return to campus for any reason must complete the Travel Reporting Form below.

Employees:

  1. Review both abroad travel CDC Level 2 and Level 3 locations (international map) and states in the United States (U.S. map) with widespread (50 cases and above) COVID-19 presence.
  2. If you have traveled to any of these locations or have been on a cruise in the last 14 days, please complete this Travel Reporting Form. If you do not meet these conditions, do not fill out the form.

Students:

  1. If you are requesting to return to campus for any length of time, please complete the Travel Reporting Form below.

In addition, all faculty, staff, and students who have traveled within the last 14 days are asked to follow CDC guidance:

  • CDC Level 3 health notice: do not return to campus and complete a 14-day self-isolation period
  • CDC Level 2 health notice: monitor health and limit interactions with others
  • Cruise ship travel: Monitor your health and and limit interactions with others for 14 days after returning from travel. This may include the recommendation to self isolate for 14 days before return to campus

If you develop any symptoms, seek medical evaluation. Call ahead before going to a doctor’s office or emergency room to prevent the spread of infection. CDC instructions for self-isolation and symptom monitoring can be found here.

For Students:

If you are a student and you believe you have been exposed to a known or suspected case of COVID-19 while traveling, please call the Student Health Service (336-758-5218) or your primary health care provider. Seek medical attention if you experience fever, cough or difficulty breathing. It is recommended that those who think they may have been exposed call ahead before going to the Student Health Service, their primary care physician, or an emergency room.

This reporting form will also allow the Student Health Service to send important instructions for monitoring during your 14-day self-isolation. Please follow any directions noted and complete any surveys emailed to you during the course of your monitoring period to avoid unnecessary calls from Student Health Service.

For WFU Faculty & Staff:

If you are a WFU faculty or staff member, you should call your local health department (Forsyth County: 336-703-3100) or your primary health care provider.

If we have questions or need to speak with you regarding the results of a submitted Travel Reporting Form, we will attempt to reach you at the phone number provided, so please ensure the number listed is your preferred method of contact.