Completion of a daily health form is required for all faculty, staff and students each day you intend to be on the CU Boulder campus. The daily health form must be completed before you arrive on campus. The form asks four brief questions related to COVID-19:
If any concerns are identified, e.g., a positive test, we’ll advise on next steps.
It takes less than one minute, and will help the CU Boulder community stay safe and healthy.
Student Daily Health Form
The Student Daily Health Form gives students an easy-to-view health indicator that faculty and others may ask to see. No personal information is provided to employers or faculty members.
Student Employee Health Form
The Student Employee Health Form helps managers know their employees are meeting compliance expectations.
Faculty & Staff Daily Health Form
Your supervisor will receive notification when a form has been completed. The supervisor does not receive the information submitted through the form.
All personal health and medical information will remain confidential. For more information about the privacy of CU Boulder information, please review CU Boulder’s Privacy Statement and Notice of Privacy Practices.
For Those Submitting the Form
For those required to complete the Daily Health Questionnaire and Illness Reporting Form for themselves, no further action is required unless signs of illness are detected or someone has had a recent close contact with a person with a confirmed or probable case of COVID-19.
When a Daily Health Questionnaire and Illness Reporting Form indicates the submitter doesn’t feel well:
When a Daily Health Questionnaire and Illness Reporting Form indicates the submitter may have had a recent close contact with someone who has a confirmed or probable COVID-19 illness:
When a Daily Health Questionnaire and Illness Reporting Form indicates the submitter has been tested for COVID- 19 and test results are “pending” or “positive,” with or without symptoms:
- The submitter will see a pop-up message advising them of next steps. The message provides directions that may include:
- Follow recommendations to self-isolate until a health care provider or public health official approves your release from isolation and you are welcomed to return to work
- Continue any recommended isolation or quarantine, and remain at home until your test results are available
- Follow your department protocols for illness notification
- Notify your supervisor and Medical Services if the test is positive
- If you have questions, contact Medical Services at 303-492-5101 or email@example.com for more information or resources
Supervisors are responsible for:
Supervisors who complete the Daily Health Questionnaire and Illness Reporting Form on behalf of someone out of the office because of possible COVID-19 symptoms, confirmed illness or close contact with a probable case should be aware:
Supervisors monitoring employee compliance should be aware: