First Name:

Last Name:

SWOCC ID Number:

Date of Birth:

Email Address:

Phone Number:

Please list your association with SWOCC:

If other, please specify:

What type of test did you take? 

What date did you take your positive test?

What date did you receive your test results?

Do you have symptoms?

If you have symptoms, what date did they start?

Were you on campus 48 hours prior to your symptoms starting OR your positive COVID test?

In the last 48 hours before your symptoms started or you tested positive, did you have any close contact with any students on the SWOCC campus?

The definition of close contact is being within 6 feet of someone for 15 minutes or more, cumulatively, over a 24 hour period of time. The definition does not change if one or both of you were masked or if you were outside.

List contacts, include class and date of contact. If you don't know the name of your contact, please include class, date, and your instructor's name & email, if possible. If you have phone numbers or emails for your contacts, please include them:

In the last 48 hours before your symptoms started or you tested positive, did you have any close contact with any faculty on the SWOCC campus?

The definition of close contact is being within 6 feet of someone for 15 minutes or more, cumulatively, over a 24 hour period of time. The definition does not change if one or both of you were masked or if you were outside.

Please provide faculty name, date of contact, and class if applicable:

In the 48 hours before your symptoms started or 48 hours before you tested positive, did you have any close contact with any SWOCC staff or management?

The definition of close contact is being within 6 feet of someone for 15 minutes or more, cumulatively, over a 24 hour period of time. The definition does not change if one or both of you were masked or if you were outside.

Please provide staff member name, date of contact, and email or phone number if possible:

Please list any campus related activities you participated in during the 48 hours prior to your symptoms starting or your positive test:

In the 48 hours prior to your symptoms starting or your positive test, please list all of the buildings you were in on campus, including the dates:

Southwestern Oregon Community College requires a 5 day isolation period after onset of symptoms or testing positive. You cannot come back to campus for any services, classes, work or activities until your 5 day isolation period is over.

Housing students should isolate in their individual assigned apartment or a temporary isolation apartment as directed by the Housing Office.

Your isolation period starts with day 0 being the first day of symptoms, or when you receive your positive test. If you have any questions about when your isolation period ends, please email covidsupport@socc.edu and we are happy to help you figure it out.