Dominican is asking that any student who has tested positive for COVID-19 (or who is in a household with someone who has been diagnosed) please voluntarily compete this form.
The purpose of this form is so that we can provide individual student support and outreach. Additionally, we want to be sure that in any situation that may impact campus, Marin County Public Health is aware and can provide assistance and guidance.
Please note that information provided on this form may be shared with various support services/offices – including, but not limited to, Student Health, Academic Support, and Student Life.
Please use this form ONLY if you have a CONFIRMED diagnosis of COVID-19, or if someone in your current household has been diagnosed.
If you think you may have been exposed, but have not yet been diagnosed, please contact your medical provider or the Student Health Center.