Staff COVID-19 Reporting Form

Please note that this is the Staff form, if you are a Student then please use the link to the Student Form.

A copy of this form will be sent to managers in your area, and you should also notify your line manager.  In addition to completing this form all sickness absence including that due to COVID-19 must be recorded on SAP (ESS or MSS) as either:

*     Coronavirus – confirmed by health professional or
*     Coronavirus – suspected in line with symptoms of fever and continuous cough.

If you are self-isolating as directed by government guidance then you must also supply a self-isolation note to your line manager, the form is available at https://111.nhs.uk/isolation-note/ . The note will be returned to you by email which you can forward to your manager.  If you do not have an email account then you can have the note sent to a trusted friend, member of your family or directly to your manager’s email.

The University needs to collect information for all staff including Unitemps workers who have either:

  • Received a negative or positive test result for COVID-19.
  • Isolating as a consequence of the latest government guidance.
  • Have been in CLOSE contact with someone suspected of having Covid-19 on University property recently - Guidance on what constitutes a contact.

We also need to know whether you are in the UK or not. This form should not be used to report any other sickness or absence or change of circumstances.

Where are you currently based?  


Notification Type   Please select one of the options below. If your information changes then please complete another form.






Self-Isolation Started If you are self-isolating then enter the date when your self-isolation began.
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If you are self-isolating then you must supply a self-isolation form to your line manager - Link to supply a self-isolation form to your line manager

Last on University Premises Enter the date on which you were last on University premises.
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Requested Test   Please indicate whether or not you have requested a COVID-19 test.


Asymptomatic Test   Please indicate whether you are not displaying any symptoms, but have requested a test for other reasons.


Tested Please enter the date of your test.
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Further guidance is also available from the Government's website at www.gov.uk/coronavirus.  This form does not replace an individual's responsibilities in respect of NHS Test and Trace.  If you are self-isolating as directed by government guidance then you must also supply a self-isolation note to your line manager, the form is available at https://111.nhs.uk/isolation-note/ . The note will be returned to you by email which you can forward to your manager.  If you do not have an email account then you can have the note sent to a trusted friend, member of your family or directly to your manager’s email.

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