Health Verification Form

The college-wide COVID-19 Health Verification Form formerly called the Health Attestation Form) is now available on my.evergreen.edu.

The form is used for two purposes:

  1. Self-check to verify that you meet the health and safety requirements to be able to come to campus. The State of Washington requires that anyone planning to come to any campus location complete this form each day before they arrive, or immediately upon arrival.
  2. Reporting COVID-19 related symptoms, diagnosis, or potential exposure. 

Completing the form

Complete the COVID-19 Health Verification form via my.evergreen.edu before coming on campus, every time you come on campus AND if you have COVID-19 symptoms, diagnosis, or exposure to report.

All students, faculty, and staff are required to fill out the form, including students living on campus, both in Olympia and in Tacoma.

Staff can request that your supervisor complete it for you via a proxy submission if you are unable to access the electronic form.

If you do not pass the verification a member from the Health Monitoring and Response team will reach out to follow up. Staff and faculty will be asked to stay home and notify your supervisor.

Access to form results

In compliance with Washington State health and safety requirements, the following people have access to your form:

  • All: Designees of the Health Monitoring and Response team
  • Students: your faculty and student employee supervisors
  • Faculty: the academic deans
  • Staff: your supervisor

Details of specific health symptoms are not saved by the institution and the form is not considered a health history.

We understand that protection of health information and health history is important for privacy, and that some of you may have concerns about this new process. We take these concerns seriously and will protect this data.

This process is a state requirement to ensure the safety of our employees, students, and the community. The form has been reviewed by the Washington State Office of the Attorney General.

Instructions for Supervisors and Faculty

Visitors

The Health & Safety Teams are actively working on a COVID-19 Health Verification process for visitors to campus.