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, isolate from other at home for 10 days from when symptoms started or, if asymptomatic, from when you tested. You may need to stay home more than 10 days if symptoms are not improving or worsen. Contact Student Health or your physician for guidance.

  3. Have you had prolonged close contact with someone who tested positive for the coronavirus? If yes, quarantine according to SCHD modified quarantine guidance.
  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, isolate from other at home for 10 days from when symptoms started or, if asymptomatic, from when you tested. You may need to stay home more than 10 days if symptoms are not improving or worsen. Contact Student Health or your physician for guidance.
  6. Have you recently traveled or plan to travel soon? Please keep check the Kansas state public health Travel & Exposure Related Isolation/Quarantine information.

  7. Are you experiencing or have you experienced any of the following symptoms? (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 or Chills
    • Fatigue
    • Repeated shaking with chills
    • Muscle pain
    • New loss of taste or smell
    • Sore throat or headache
    • Congestion or runny nose
    • Diarrhea
    • Nausea or vomiting

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.