UIndy Health Check 21-22

  • This form is for UIndy students, faculty, and staff. The Health Check for Visitors form is available for UIndy visitors.

    All unvaccinated individuals are required to fill out the UIndy Health Check every day they come to campus.

    You must complete the form on the day—NOT the day before—you will be:
    1. coming to campus OR
    2. attending a university sanctioned or sponsored event, including internships, practicums, and field experience
    Based on the results of this form, you will receive an approval to be on campus or a communication from UIndy’s contract tracing team about your next steps.

  • Please enter the best phone number to reach you.
  • Fully vaccinated is defined as two or more weeks passed a) since your second dose of the Pfizer or Moderna vaccine or b) since receiving the Johnson & Johnson vaccine.
  • Before coming to campus, all vaccinated students, faculty, and staff who are experiencing possible COVID-19 symptoms should call Contact Tracing at (317) 788-6131 between 9:00 a.m. and 4:30 p.m. or Kory Vitangeli at (317) 523-1609 before/after hours.
  • Fever or chills
    New cough
    Shortness of breath
    New loss of taste or smell
    Sore throat
    Congestion or runny nose (excluding seasonal allergies)
    New unexplained fatigue
    Muscle or body aches
    Nausea or vomiting
    New headache
    Diarrhea
  • Close contact is defined as less than 6 feet away for more than 15 minutes.
  • By clicking the SUBMIT button below, I affirm that any information I submit through the UIndy Health Check Web Form is true and accurate to the best of my knowledge and that all information I submit is specific and personal to me as the Web Form user. I understand that if I submit false information using the name and/or email address of any other person, I may be subject to disciplinary action for violation of UIndy policies and codes of conduct.