The purpose of the questionnaire is for you to self-observe your daily health prior to coming to campus. It was developed with criteria from the CDC.

Take your temperature every day before coming to campus and write it down. If your temperature is greater than 100 degrees or if you answer YES to any of the following questions, please stay home and contact Student Health Services (316-978-4792) or your health care provider.


Please answer the following questions:

  1. Have you been tested for the coronavirus (awaiting results)?  If yes, stay home until results are received.
  2. Have you tested POSITIVE for the coronavirus?  If yes, stay home for 14 days after symptoms are gone.
  3. Have you had prolonged close contact with someone who tested positive for the coronavirus? If yes, stay home for 14 days and return to campus if there are no symptoms.
  4. Has a member of your household been tested for the coronavirus (awaiting results)? If yes, stay home until results are received.
  5. Has a member of your household been asked by a medical professional to isolate for potential coronavirus? If Yes, stay home for 14 days and return to campus when there are no symptoms.
  6. Have you traveled out of the country within the last 14 days? If yes, stay home afor 14 days from your arrival back in the United States. Return to campus if there are no symptoms
  7. Have you taken a cruise within the last 14 days? If yes, stay home for 14 days from your arrival back in the United States. Return to campus if there are no symptoms.
  8. Are you experiencing or have you experienced any of the following symptoms in the past 14 days? (If you answer yes to at least one of these questions, please stay home and call your healthcare provider.)
    • Cough (not related to allergies)
    • Shortness of breath
    • Difficulty breathing
    • Fever
    • Chills
    • Repeated shaking with chills
    • Muscle pain
    • New loss of taste or smell
    • Sore throat or headache

Once you begin your day on campus, continue to observe yourself for any changes such as fever, coughing and/or difficulty breathing.

What to do if your condition changes while at work or at home

If you feel feverish or develop a cough or have difficulty breathing during the self-observation period, you should:

  • Take your temperature and write it down.
  • Self-isolate (6-feet distance between you and others)
  • Seek advice by telephone from your healthcare provider or Student Health Services.