Dear Faculty and Staff,

Reducing the spread of COVID-19 is everyone’s responsibility. By monitoring for symptoms, possible exposures of COVID - 19,  and getting tested when needed will help keep our community safer.


Please read and and attest to the following questions.

1.  Have you tested positive for or been diagnosed with COVID-19 within the last 10 calendar days?

2. Have you been in close and prolonged physical contact (within less than 6 feet for at
least 15 minutes or more throughout a 24 hour period) with an individual who has tested positive for or been diagnosed with COVID-19, or exposed to their cough or sneeze, within the last 14 calendar days?

3.  Have you had a fever or felt feverish without taking any fever-reducing medication to reduce a fever in past 24 hours?

4.  Have you had a cough, shortness of breath, sore throat, muscle aches, fatigue, nausea, vomiting, diarrhea, congestion, runny nose, or loss of taste or smell or any other symptoms of COVID-19, within the last 10 days?
(persons with preexisting conditions should consult a medical provider for a plan of care)

5. In the last 14 days, have you attended a social gathering that exceeded the Minnesota Executive Order:   Indoor social gatherings to groups of up to two households, up to a maximum of 10 people or outdoor social gatherings are up to three households, up to a maximum of 15 people?
 

If you can attest to all of the statements above by answering "no," please sign this form electronically below.  After completing the form, you will be able to come to campus.

If you cannot attest to one or more of these statements (any "yes" answers), you should stay at your residence to monitor your health until you can answer "no" to all of the questions.  When you can attest to all the statements above with "no" answers, please sign this form electronically and you will then be able to return to campus.

Every day from here forward that you need to come to campus, please review these questions to ensure the safety of our campus.  On any day in which you answer "yes" to one or more of these of these statements, you should stay at your residence to monitor your health until you can answer "no" to all of the statements.

If you answer "yes" to more than one question or if symptoms related to one or more questions are severe, contact your personal health care provider to develop an appropriate plan for care or testing.

Sincerely,

Chancellor Mary