The college-wide COVID-19 Health Verification Form (formerly called the Health Attestation Form) is now available on

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 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.

Health Verification Badge

You may be asked to show this “badge” when accessing services or spaces on campus (see next section for details).

Once you complete your Health Verification Form you will find the badge on the my.evergreen homepage by clicking View Health Verification status in the right sidebar, under the heading COVID-19 Health Verification

Orange badge symbol with the accompanying text. COVID-19 Health Verification Status. No completed verification for today. Please submit your COVID 19 Health Verification if you plan on coming to campus today.

Example Health Verification Badge

Showing Your Health Verification Badge

There are a few ways that Evergreen is responsible for monitoring the COVID health status of employees, students, and visitors. There are instances when someone other than your COVID supervisor will confirm your status. An overview of the process is outlined below. 

  • Initial screening is completing the HVF prior to the in-person activity
  • Compliance monitoring is COVID Supervisors ensuring that students and employees in their areas follow the health screening policy
  • On-site screening is a screening that happens person-to-person for drop-in activities or services 
    • It is required to access any indoor in-person activities or outdoor in-person activities lasting more than 5 minutes for which compliance monitoring is not possible, such as for unscheduled services and activities. 
    • This is when you’ll use your badge! 
    • If you can’t show a badge, either because you didn’t complete the HVF yet or you don’t have a my.evergreen login, you will need to complete a paper health verification 
  • Paper health verification options will be provided at any on-site screening locations for visitors without a my.evergreen login or those unable to complete the online form. 

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 Assessment 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


All visitors to campus locations and in-person services or activities must follow the screening process outlined above.