COVID-19 Disclosure and International Travel Form

Please fill out this form if you have been exposed or diagnosed with COVID-19, if you have upcoming international travel plans, or have traveled internationally.

In accordance with Goodwin University’s COVID-19 International Travel and Exposure Disclosure Procedure all members of the Goodwin community, including students, faculty, staff and campus-based third-party vendors, must complete this form as soon as practicably possible. For more information on this policy, and what’s being done to keep the Goodwin community safe, visit the webpage.

Your information will be protected, and will only be shared on an as-needed basis.

Your Information
Travel #1
Type of Travel  
Travel #2
Type of Travel  
Travel #3
Type of Travel