COVID-19 Reporting Form
for Cal Poly Faculty, Staff, and Student Assistant Employees
Cal Poly Employees working on campus must report if they test positive for COVID-19, are experiencing symptoms, or had a close contact with an infected person and have been on campus in the past fourteen (14) days. Please access and submit the COVID-19 REPORTING FORM below:
Your personal health information will be kept confidential and will only be shared as required by law.
Auxiliary employees, including ASI and CPC, DO NOT COMPLETE THIS FORM. Please consult with your appropriate Human Resources Department for details on how to report.
If you are a Cal Poly state employee (faculty, staff or student employee):
- Complete the COVID-19 Online Reporting Form or ask someone to report on your behalf.
- Expect to receive a call from a member of the Cal Poly COVID-19 Response Team who will ask you a few questions and provide you information. Your private health information will be kept confidential and will only be shared as required by law.
If you are a department chair/head or appropriate administrator and are notified by an employee that they tested positive, are experiencing symptoms or had a close contact with an infected person:
- Ensure the COVID-19 Online Reporting Form is completed. The Employee’s supervisor can submit the online form on the employee’s behalf.
- Inform the employee to expect a call from a member of the Cal Poly COVID-19 Response Team and assure them that their health information will be kept confidential. Do not share this information with others.