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University of Dallas COVID-19 Visitor Screening Form
In response to the COVID-19 pandemic, the University of Dallas is taking extra precautions with visitors to help ensure the health and safety of our campus community. All visitors to the university must fill out this screening form in order to spend time on campus.
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Name
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Your answer
Phone Number
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Your answer
E-mail
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Your answer
Purpose of Visit/Department
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Your answer
As a visitor to the University of Dallas, I hereby certify:
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I am not currently experiencing symptoms of COVID-19, including fever of 100.4 or higher, cough, shortness of breath, new loss of sense of taste/smell, sore throat, dizziness, chills/body aches, or gastrointestinal distress, AND
I have not had close contact with a positive or presumed-positive (i.e. exhibiting symptoms and instructed to quarantine by a healthcare provider) individual with in the last 14 days, AND
I will wear a mask and maintain 6 ft. of social distance while in buildings on campus, and I will maintain 6 ft. of social distance while outside on campus.
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Please type your name and today's date to serve as an electronic signature:
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