JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
REPORTING THE COVID-19 RELATED INCIDENTS IN OUSL
Please complete this report completely. This will be communicated to the OUSL-COVID-19 response task force and PHI-OUSL will contact you shortly after this report.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Date :
MM
/
DD
/
YYYY
Time:
Time
:
AM
PM
Faculty / Institute & Center :
Choose
Faculty of Education
Faculty of Engineering Technology
Faculty of Health Sciences
Faculty of Humanities and Social Sciences
Faculty of Natural Sciences
Faculty Management Studies.
Post Graduate Institute of English
Centre for Educational Technology & Media (CETMe)
Centre for Env. Stu. & Sustainable Development (CESSD)
Regional & Study Centers
Centre For National Online Distance Education Service (C-Nodes)
Centre for Quality Assurance (CQA)
Central Campus
Department / Division :
Choose
Early Childhood and Primary Education
Secondary & Tertiary
Special Needs
Educational Leadership and Management
Agricultural and Plantation Engineering
Civil Engineering
Electrical and Computer Engineering
Mechanical Engineering
Mathematics and Philosophy of Engineering
Textile and Apparel Technology
Basic Sciences
Health Edu and Research
Medical Laboratory Sc
Nursing
Pharmacy
Psychology and Counselling
Legal Studies
Language Studies
Social Studies
English Language Teaching (DELT)
Botany
Chemistry
Computer Science
Mathematics
Physics
Zoology
Organizational Studies
Accounting and Finance
Human Resource Management
Marketing Management
Public Information
RES Division
International Relations
Quality Assurance
Research Unit
Operations Division
Capital Works
VC Office
DVC Office
General Administration
Registrar's Office
Deputy Registrar's Office
Student Welfare
Security Division
Finance
Establishment
Supplies
Internal Audit
Legal Office
Examination
IT
Transport
Regional Centers / Study Centers
Exact place of incident:
Your answer
Staff / Student:
Staff
Student
Clear selection
Name of the reporting person:
Your answer
Contact Address (Permanent / Temporary)
Your answer
E-Mail :
Your answer
Name of the suspected COVID-19 case (if different from above):
Your answer
Level of exposure:
Choose
Confirmed Positive
Unconfirmed with symptoms
1st contact
Last date of his / her attendance to the OUSL:
MM
/
DD
/
YYYY
Contact Telephone number:
Your answer
Place of residence of the COVID-19 case:
Your answer
Further information regarding the situation:
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of The Open University of Sri Lanka (OUSL).
Report Abuse
Forms
