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COVID-19 exposure form
Fill out this form if you have been notified that you have been in contact with someone that has COVID-19
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* Indicates required question
Email
*
Your email
Name
*
Your answer
L number
*
Your answer
Phone number
*
Your answer
Date of Birth
MM
/
DD
/
YYYY
Date of exposure if known
MM
/
DD
/
YYYY
Did the exposure happen on campus?
*
Yes
No
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