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This information will be sent to Jennifer Dean, Director of Health Services, if student is selected.
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Before you submit this form, please complete the initial screening by using the Apple Screening App or Google FormGoogle Form. This form should be completed if the daily screening has indicated that you have COVID-19 symptoms or possible exposure.
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Vice President or Supervisor indicated will receive notification.
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Vice President or Supervisor indicated will receive notification.
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Resident Director indicated will receive notification
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Sport
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Check all that apply
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