To ensure that Lorain County Community College can provide support and resources to those who have been exposed to or tested positive for COVID-19, the College is requesting that individuals complete the form below if they suspect or know that they have COVID-19. This information will also assist LCCC and public health officials with monitoring the incidence of cases occurring in our community.


More About COVID-19

The Centers for Disease Control and Prevention (CDC)

The Ohio Department of Health

Lorain County Public Health


Please Note: LCCC is committed to ensuring that your submission remains private and only will be utilized as a means to provide support and resources. Your submission is not a substitute for medical advice. If you are in medical distress, please call 911. If someone is diagnosed with a confirmed case, local county health departments work to make sure those who have been exposed are contacted. The employee may choose to self-disclose medical information to anyone of their choosing, but that still does not allow supervisors/managers, HR, college leadership, or colleagues to re-release or discuss that information to or with that employee’s colleagues.


  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Reason for self-reporting
  • What is your vaccination status?