NGU COVID-19 Reporting Form

Do you have an NGU Identification Number?*

Employees of NGU

What was your last day at work?*
What date were you tested?*
When did you receive your results?*
When did you receive your positive results?*
When did you receive your previous positive results?*
When were you fully vaccinated?*
What was the date of your exposure?*

I acknowledge that by submitting this form that I am giving my permission to be contacted by a North Greenville University Contact Tracer, and have information shared with university personnel as needed.

Students of NGU

What date were you tested?*
When did you receive your positive results?*
When did you receive your results?*
When did you receive your previous positive results?*
When were you fully vaccinated?*
What was the date you were exposed?*

I acknowledge that by submitting this form that I am giving my permission to be contacted by a North Greenville University Contact Tracer, and have information shared with university personnel as needed.

What date were you tested?*
When did you receive your results?*
When did you receive your positive results?*
When did you receive your previous positive results?*
When were you fully vaccinated?*
What was the date your were exposed?*

I acknowledge that by submitting this form that I am giving my permission to be contacted by a North Greenville University Contact Tracer, and have information shared with university personnel as needed.