COVID-19 – Report a Case

This online form was developed to give the EWU campus community a method for reporting a confirmed or suspected case of Covid-19, or for reporting close contact with a person affected with Covid-19.

Community members may report Covid-19 cases using this online form, by calling 509-359-6900, or by emailing the University Risk Manager at riskmanager@ewu.edu

WHO IS THIS REPORT FOR?
Are you reporting a Covid case for yourself or for someone else?
- Myself
- Someone Else
Your Name * Required
Your Phone Number * Required
Email * Required
Your Date of Birth
Your Status
- EWU Student
- EWU Faculty/Staff
- EWU Student Employee or GSA
Covid Information
Reason for Report
Note: Close contact is defined as being within 6 feet of a person for 15 minutes or longer within a 24-hour period.
- I have a Confirmed Case of COVID-19
- I have COVID-19 Symptoms
- I have been in close contact with a person with a confirmed case of COVID-19
COVID-19 Test
Have you been tested for COVID-19?
- Yes - Test Result Positive
- Yes - Test Result Negative
- Yes - Awaiting Results
- No - Not Tested
Last Date of Contact with Positive Case - must be mm/dd/yyyy format
MM slash DD slash YYYY
Date of Test - must be mm/dd/yyyy format
MM slash DD slash YYYY
Date Symptoms Began - must be mm/dd/yyyy format
MM slash DD slash YYYY
Your Vaccination Status
Please indicate your vaccination status.
- Vaccinated
- Partially Vaccinated (single dose of MRNA vaccine)
- Vaccinated and Received Booster
- Unvaccinated
Date of Booster - must be mm/dd/yyyy format
Date you received booster dose of vaccine
MM slash DD slash YYYY
Hospitalized
Has you been admitted to a hospital?
- Yes
- No
Close Contacts
A close contact is someone that you were within 6 feet of for 15 minutes or longer or someone that lives with you. Please list any of your close contacts here:
Reporting Person Contact Information
You are not required to provide your contact information. However, it may be helpful for university officials to be able to contact you for additional information.
What is your name? (Optional)
What is your Email? (Optional)
What is your phone number (Optional)
Affected Person(s)
Name of person affected with or exposed to COVID-19 * Required
Who is the primary person who you believe has contracted or been exposed to COVID-19?
Phone number of person affected with or exposed to COVID-19
Email address of person affected with or exposed to COVID-19
Date of birth of person affected with or exposed to COVID-19 (if known)
Covid Information
Relationship of Person to EWU
What is the relationship of the person to EWU?
- EWU Student
- EWU Faculty/Staff
- EWU Student Employee or GSA
Status of the Affected Person
Note: Close contact is defined as being within 6 feet of a person for 15 minutes or longer within a 24-hour period.
- Confirmed Case of COVID-19
- COVID-19 Symptoms
- Been in close contact with a person with a confirmed case of COVID-19
COVID-19 Testing
Has the affected person been tested for COVID-19?
- Yes - Test Result Positive
- Yes - Test Result Negative
- Yes - Awaiting Results
- No - Not Tested
- Unsure
Last Date of Contact with the Positive Case - must be mm/dd/yyyy format
MM slash DD slash YYYY
Date of Test - must be mm/dd/yyyy format
MM slash DD slash YYYY
Date Symptoms Began - must be mm/dd/yyyy format
MM slash DD slash YYYY
Vaccination / Booster
Please indicate the person's vaccination status if you know it.
- Vaccinated
- Partially Vaccinated (single dose of MRNA vaccine)
- Vaccinated and Received Booster
- Unvaccinated
- Unknown
Date of Booster - must be mm/dd/yyyy format
Date the person received booster dose of vaccine if known.
MM slash DD slash YYYY
Hospitalized
Has the person been admitted to a hospital?
- Yes
- No
- Unknown
Close Contacts of the Affected Person
A close contact is someone that the affected person was within 6 feet of for 15 minutes or longer or someone that lives with them. Please list any close contacts of the affected person here:
Campus Contact
Have you been on any EWU campus during the infectious period?
Note: The infectious period is two days before symptoms began (or test date with no symptoms) until five days after the symptoms began (or test date with no symptoms).
- Yes
- No
Which EWU Campus(es) did you visit?
Do you live on campus?
- Yes
- No
Residence Hall & Room or Apartment
If you live on campus, please enter your residence hall and room number or your apartment number.
Additional Information
Campus Contact
Has the affected person been on any EWU campus during the infectious period??
Note: The infectious period is two days before symptoms began (or test date with no symptoms) until five days after the symptoms began (or test date with no symptoms).
- Yes
- No
- Unknown
Which EWU Campus(es) did the affected person visit?
Does the affected person live on campus?
- Yes
- No
- Unknown
Residence Hall & Room or Apartment
Please enter the person's residence hall and room number or apartment number if known.
Additional Information

Covid Information

Reporting Person Contact Information

Affected Person(s)

Covid Information

Campus Contact

Campus Contact