Authorization to Share COVID-19 Information

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Click here for information about Highland Community College and COVID.

A consent form is required for all students who will be participating in the weekly COVID-19 screening test. Students will be notified of their status by SHIELD Illinois approximately 24 hours after the screening test. The consent form permits SHIELD Illinois to also release COVID-19 status to the Illinois Department of Public Health and Highland Community College. The consent form is required if you plan to utilize the free SHIELD Illinois screening test service on Highland's campus.

Download this form here.

Please print this form and sign it. If you are a minor (under 18 years of age), the signature of a parent or guardian is also required. 

After this form has been completed, you may also choose to submit the completed form electronically using this web page. You may also choose to turn in the form to a staff member in enrollment services during business hours (Student/Conference Center on the second floor of Building H, or to Student Services on the first floor of Building H).

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Contact Us

Questions? Contact Student Services:
phone: 815.599.3414 
in person: Building H (Student/Conference Center), second floor