Notification form Corona

First name

Last name

Student ID

Campus

Mobile

E-mail

Are you quarantined or isolated? Yes, in quarantine Yes, in isolation No

Have you been tested? Yes, I've tested positive Yes, I've tested negative Yes, waiting for results No

Did you visit campus in the last 48 hours before you first noticed symptoms/became sick? Yes No

Have you been physically present in class during this period? Yes No

If yes, which lectures/classes?