NMT COVID-19 Self-Report Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

(Updated 10/02/23) PLEASE READ BEFORE SUMBITTING.

If you are a NMT student who tested positive for COVID-19 lives on campus, needs assistance during quarantine with food services or seeking medical assistance, etc. please continue with submitting this form.

If you are Faculty/Staff/Student and test positive for COVID-19 you are no longer required to use this form to report your status however, you are still required to follow CDC COVID-19 guidelines which you can find on the CDC Website here: https://www.cdc.gov/coronavirus/2019-ncov/your-health/isolation.html. Please use the CDC Isolation and Exposure Calculator which is a tool to help you determine if you need to isolate, take other steps, or seek medical attention.

Please contact your supervisor to report your isolation/illness and check with HR if you have any questions regarding your leave options.

If you still have questions or are unsure of next steps, please contact the Office of the President at 575-835-5600 or president@nmt.edu

Report Type: *

This report is for Students ONLY needing assistance during isolation: If you are faculty/staff you are no longer required to use this form to report your status.

Clear form

Never submit passwords through Google Forms.

This form was created inside of New Mexico Tech. Report Abuse

Forms