Any South Suburban College employees and students who have tested positive for COVID-19 are strongly encouraged to self-report in accordance with the Cook County Department of Public Health and to support the safety of the SSC community. Please complete this form with as much information as possible. Privacy will be respected and individual identification will only be utilized for the purposes of contact tracing.

DO NOT COMPLETE THIS FORM FOR SUSPECTED CASES OF COVID-19 — EMAIL ICARE@SSC.EDU.
This information is secured and will not be used to determine residency status for tuition purposes.

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* Student's Contact Information

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* Last Date on Campus

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* Locations Visited on Campus

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* Last Date of Contact with SSC Colleagues, Faculty or other Students

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* Names of Individuals in Contact with:

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* Date of Exposure

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* Date of Positive Test

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* Exhibited any symptoms and, if so, when and what:

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