Covid-19 Self-Reporting

Students and employees are requested to self-report if they have tested positive for COVID-19. This self-reporting form is an online, short questionnaire that can be filled out on a PC or mobile device, even a cell phone. Please note that Southwest will take all appropriate steps to protect an individual’s privacy in accordance with applicable law, but cannot assure complete confidentiality of the form when the health and safety of students, employees and visitors depends upon appropriate sharing of information to parties such as public health officials. Typically, information gathered will remain confidential as directed by the Shelby County Health Department. The College will notify the Shelby County Health Department, but will NOT divulge the identity of the person(s) in question to the greater campus or Memphis communities. The College will also assess the credibility of every self-report to determine whether to provide an update to the campus community. For specific regulations on HIPAA Privacy and sharing patient information, click here. 

Please completely fill out the form below. 

Thank you for helping us to promote health and wellness at our locations. 

ALERT: This self-reporting system is for students, faculty, staff and campus visitors who have received a POSITIVE test result for covid-19.