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Health and Safety Form

Faculty, staff, or students who are staying home due to illness should complete this confidential health and safety intake form. A nurse from the QCC Health and Wellness Team will contact you. 

Please use the General Illness Form for illness intake.

If you need immediate medical attention, call 911.

swhitters [at] qcc.mass.edu (subject: Webform%3A%20Help) (Need help?)

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