RFUMS COVID-19 Faculty/Staff Reporting Form
This form is utilized by Rosalind Franklin University of Medicine and Science faculty and staff to report they are experiencing symptoms, a possible exposure, or have suspected or confirmed cases of COVID-19 (Coronavirus). Faculty and staff are required to submit this form detailing possible exposure if an immediate family member or resident of their household is experiencing symptoms, suspect, or have a confirmed case of COVID-19.
The information on this form is submitted directly to the Office of Human Resources for review and a staff member will be in contact with you as soon as possible. It is important to note that if you are filling out this form you should NOT attend work or activities on campus or at an affiliated site until being cleared by Human Resources. If you are in need of immediate assistance please contact 847-578-3266 Monday-Friday 8:30a.m.-4:30p.m., or after hours and on the weekend please contact Campus Safety at 847-578-3288.