COVID-19 Exposure Reporting Form
Students and employees who are experiencing COVID-related symptoms, who believe they have been exposed to COVID-19, or have tested positive must report that information to HR immediately.
You may use this form or call Human Resources at 563-336-3341.
If you have reported an exposure, symptom or positive test result, do not come to campus until cleared by Human Resources.
Requirements for returning to campus after exposure are outlined in the EICC COVID-19 Positive and Presumed Positive Protocols.
Please use this form to submit/self-submit a report of COVID-19 symptoms, exposure or positive results.
Asterisk (*) indicates a response is required.
Please make sure after clicking the submit button that you receive a confirmation message on the screen and copy of your submission at the email address you provided. If you do not receive a confirmation message and email, your submission was not completed and has not been sent.