St. Mary\\\'s University
Employee Self-Reporting Form
All StMU community members should register and await further instructions if they meet any of the following:
You have tested positive for COVID-19 or are showing symptoms for COVID-19.
Someone in your immediate family or someone you share close contact with has tested positive for COVID-19 or is showing symptoms for COVID-19.
Any and all information gathered through the University registration process will remain as private as possible, and will only be shared as public health or the preservation of our campus community’s safety dictates. In such instances, this information release will be limited and carefully managed.
Faculty and staff who do not meet any of the criteria above but who are ill with high fever, or cold and flu symptoms should stay home and obtain further advice and documentation from their personal physician.
Questions about the reporting process can be directed to humanresources@stmarytx.edu.
Select which of the following is true for you:
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I have tested positive for COVID-19 or I am showing symptoms of COVID-19.
Someone in your immediate family or someone you share close contact with has tested positive for COVID-19 or is showing symptoms for COVID-19.
Other
None of these is true. IF YOU SELECT THIS OPTION, YOU DO NOT NEED TO SELF-REPORT.
If you selected the option "Other" above, please explain.
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Your Name
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First
Last
Your Direct Supervisor's Name
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First
Last
Your position and work area (Examples: Math Professor/SET or Housekeeping/Facilities)
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Your St. Mary's email address.
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A number we can reach you (cell or home)
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Name of your emergency contact
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First
Last
Phone Number for your emergency contact
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Check the box below to confirm that you understand you MUST wait for further instructions before returning to campus
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I understand I must wait for further instructions before returning to campus.
Do Not Fill This Out
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