COVID-19: Self-Disclosure Form

Arcadia University maintains confidentiality for our community to report information about the number of confirmed COVID-19 cases among students and University employees on campus. This information only includes such cases that have been reported to the University through our health and safety and established reporting protocols.

Using the Form

This form should be used by Arcadia students or employees (faculty and staff) who have tested positive for COVID-19 OR who have been identified as coming into close contact with someone who tested positive recently. Whether you are working from home or have been on campus, you should use this form accordingly. Submissions are considered confidential and will not be shared in detail.

I’m feeling sick. What do I do?

A quick reference guide.

For Students

For Employees

Questions or Concerns?

Know the Symptoms
Call Student Health Services to schedule a phone evaluation.
Did you test positive for COVID-19?
- Fill out the Self-Disclosure Form.

Know the Symptoms
Call your PCP.
Did you test positive for COVID-19?
- Call your Supervisor.
Did you test positive for COVID-19, and you were recently on campus? Did someone in your home recently test positive?
- Use the Self-Disclosure Form

Have you been in close contact with someone positive?
I visited campus within 48 hours and tested positive. What should I do?
Someone in my home has COVID, what should I do?

Any Arcadia community member (students and employees) who have questions can contact COVIDCareTeam@arcadia.edu.

I’ve reported my positive test. What’s the next step?

Once you self report you will be contacted by a member of the Arcadia University Contact Tracing Team shortly. This team will help you trace your most recent movements and contact those who may need to be informed they have been exposed to COVID-19.

#ArcadiaStrong

Anyone who tests positive for COVID-19 and has been on campus puts our community at risk for exposure. As per our health and safety guidelines and those from the Pennsylvania Department of Health and Centers for Disease Control and Prevention, you must isolate yourself if you test positive. You may be contacted by a member of Arcadia’s contact tracing team and asked to self-quarantine. Thank you for helping our community remain #ArcadiaStrong and stopping the spread of COVID-19.

First Name
Last Name
Email
Mobile
Contact Type:

Please select your campus:

Are you a Graduate or Undergraduate Student?:

If you are a graduate student, indicate your program of study and campus:
Residency type (Required):

Are you an athlete? If so, what team?:

What are you reporting?:

Date of your COVID test:
If you were a close contact, what was your most recent exposure date?
What Arcadia University events or activities (not including classes) have you attended in the two days prior to and the day of your positive test? Indicate events/activities and the dates attended.
FOR STUDENTS ONLY: Please list any roommates/housemates you had contact with in the two days prior to and the day of your positive test. What was the date of your last contact with them?
FOR STUDENTS ONLY: Please list any intimate contacts you had in the two days prior to and the day of your positive test. What was the date of your last contact with them?
Arcadia community members who test positive for COVID are responsible for notifying individuals whom they came into close contact with during the 2 days prior to and day of their positive test. A close contact is someone with whom you were in very close proximity to, including touching, indoors for approximately 15 minutes or more. Below is an email template that you should use to notify your close contacts as it provides them with instructions on how to proceed. Regardless of how you notify your close contacts, you need to convey to them the date of the exposure, when they should get tested, and that they should wear a mask for 10 days after the exposure. Do you have any close contacts that you would like help notifying?
Questions or Concerns?:

You should send individuals this email to notify them that they are a close contact:

“I am reaching out because you were identified as a COVID-19 close contact with exposure on [insert most recent exposure date here] date. You are being asked to monitor for symptoms, wear a mask for 10 days, and take a test 6 days from this close contact exposure date. That exposure date is Day 0. If that test is positive please fill out a self disclosure form: COVID-19: Self-Disclosure Form | Arcadia University

If you develop any symptoms prior to your test date, please test and if positive complete the self disclosure form and isolate. If that test is negative, please still test on day 6 which is stated above.

You may choose to perform an at-home test, have your test at another location, or if you are a student may call SHS at 215-572-2966 to schedule a COVID test. If you have any questions please contact the COVID Care Team at COVIDCareTeam@arcadia.edu or visit Arcadia’s COVID webpage.”

COVID-19

Contact Information

Any Arcadia community member (students and employees) who have questions can contact COVIDCareTeam@arcadia.edu.