COVID-19 Referral Form

If you or someone you know has tested positive for COVID-19 please complete the COVID-19 Referral Form. Please fill out the form with as much information as you can provide, whether you are filling it out for yourself or for someone else. Please know that you have the right to keep medical information private and can do so by completing parts of the form that you feel comfortable with. Information that you provide here will be carefully shared with members of the University of Portland COVID-19 Response Team, the University Care Team, and may be accessed on a need-to-know basis as we develop an individualized plan to support students affected by COVID-19.

After you submit the COVID-19 Referral Form someone will reach 
out to offer support and connect the student to resources.

If you have any questions about this process please contact the Interim Coordinator for Student Well-Being, Ian Robins, at (503) 943-7709 or robins@up.edu.

You can find more information about University of Portland's response to COVID-19 by clicking here.