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Ingham County On-Site Work Form

Dear Colleagues,

As you are aware, the Ingham County Health Department issued an amended emergency order (3/29/20) requiring health screenings of all workers who continue to report for essential operations. This order is effective March 27 through April 13, which we anticipate will be extended.

The amended order applies to all MSU employees working on campus or at another affiliated location in Ingham County. This email is to communicate the availability of an online self-check-in tool developed to support compliance with the health screening requirement for MSU researchers that have been approved by their supervisor to continue essential research activities under the “Minimum Basic Operations” criteria. We are aware that other units on campus have already implemented their own processes or electronic versions of the screening form. Individuals in those units are not required to use the survey tool provided here and we are simply sharing it with you as an option to promote the implementation of the Ingham County requirement within your unit. Whether or not this tool is used, employees and supervisors should verify that they are meeting the requirements of the emergency order.

The form can be found on the Research Continuity website at https://vp.research.msu.edu/coronavirus or you can bookmark it directly at https://spa.msu.edu/PL/Portal/COVID19/HealthScreeningForm.aspx.

The electronic form is designed to be used by faculty, staff and students involved in essential research activities EACH TIME they are visiting campus or an affiliated location during the time period listed above.

[Please note:  Authorization to show up at a worksite is separate from the self-check-in screening process.]

MSU employees who have been approved to conduct essential research activities on campus should:

  • Complete the form PRIOR to visiting an MSU campus facility on the day of the planned visit. It does require logging in to the MSU system.
  • After completing the form, you may proceed to the location of work only if you respond “no” to ALL of the screening questions*.
  • It is also important to observe social distancing measures while at the worksite, practice recommended hand-washing hygiene, follow lab implemented plans for disinfecting surfaces, use appropriate personal protective equipment, and remain on campus the least amount of time possible to complete your work.


* Those involved in the delivery of health care are exempt from certain criteria.

Upon submission, an email will be sent to the employee and their supervisor stating whether or not the otherwise eligible employee can report to work based on their responses. If a supervisor is not defined in MSU’s human resource system, the notification will go to the associated Chair(s) or Director(s). In cases where the employee is at the Chair or Director level, the email notification will be sent to the associated Dean(s).

If you have questions about any of the information collected in this form or why this information is required, please review the amended emergency order referenced above. Supervisors in the research area can direct questions to their college’s Associate Dean for Research. If any problems occur with the Health Screening Form, please inform systems@osp.msu.edu and have employees use an alternative method (such as email) to communicate the information required by the amended emergency order referenced above for the immediate visit with their supervisors. It is the intent that the specific responses to the health screening questions will not be shared.

Our top priority is the protection of human health and wellbeing. We appreciate your cooperation with this critically important request.

With best regards,

Stephen Hsu
Senior Vice President for Research and Innovation

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