In following best practices for protecting public health related to Coronavirus (COVID-19), Rose-Hulman is asking faculty, staff, students and prospective visitors to complete this voluntary form on where they’ve traveled to in the past 14 days, or if they have exhibited symptoms related to COVID-19.

If, after completing the form, you travel or exhibit symptoms before coming to campus, please update and resubmit this form with that information.

For more information on COVID-19, visit

We appreciate your cooperation in protecting the health of our campus and community.

Travel and Symptoms Form: Students, Faculty and Staff

Travel and Symptoms Form: Visitors

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