Voluntary COVID Self-report Form
The survey below is entirely voluntary. We are creating a way for students to anonymously self-report a positive COVID status for themselves or having had close contact with an individual who has a positive COVID status. It was developed to assist faculty in the Department of Toxicology and Cancer Biology in determining the need to have classes in-person or online. COVID testing results are protected by HIPAA and faculty may not be contacted by contact tracers. If you have tested positive or have been in close contact with someone (such as living with that person) that has tested positive, please consider completing this anonymous survey so that our faculty can make informed decisions regarding the modes of course deliveries. This anonymous information will be shared with the Director of Graduate Studies of the Department of Toxicology and Cancer Biology, Dr. Isabel Mellon. Your participation is this survey is fully voluntary, but we do ask for your help by participating.

This survey will remain open until further notice. You can also submit multiple times if needed.
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I have tested positive for a COVID-19 test within the past 2 weeks *
If your COVID-19 test was positive, are you working with UK Healthcare, UK HealthCorps, or some other agency on contact tracing?
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Someone in my household or someone who I have been in close contact with has tested positive for COVID-19 within the past 2 weeks. *
What courses offered by the Department of Toxicology & Cancer Biology are you currently enrolled in that have had meetings or are currently meeting in-person? *
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