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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:



COVID-19 Reporting Form

This form requires that you first authenticate with the Cal Poly Portal.

Login to view & submit the reporting form

You may also call Human Resources at 805-756-2236 to report the required information.

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):
    1. Stay home and notify your supervisor of your absence.
    2. Complete the COVID-19 Online Reporting Form, or call Human Resources at 805-756-2236; or ask someone to report on your behalf.
    3. 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 and resources in accordance with the campus COVID-19 Prevention Plan, the Department of Public Health, and state legislation. 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:
    1. Advise the employee to stay home.
    2. Ensure the COVID-19 Online Reporting Form is completed by:
      1. Submitting the online form on behalf of the employee, or
      2. Directing the employee to the online form for completion, or
      3. Calling or directing the employee to call Human Resources at 805-756-2236.
    3. 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.
    4. Arrange telework assignment if employee is well enough to work and telework is available and/or make arrangements to cover the employee’s duties.

Covid Prevention Plan

This COVID Prevention Plan is designed to control exposures to the SARS-CoV-2 virus that may occur in our workplace and fulfil requirements of Cal-OSHA’s Emergency Temporary Standard for COVID-19, CCR, Title 8, section 3205.