Approval Request Form for On-Campus HHD Visitors

Complete this form for visitors coming to the UP campus. Please see the full guideline for a definition of visitors and an explanation of who is excluded from this request process and read the guideline carefully. https://hhd.psu.edu/about/hhd-covid-19-response/additional-resources-and-references/campus-visitors Requestors will receive notification via email on the outcome of their request. Note that, for approved visits, the requestor will be responsible for obtaining a completed HHD – COVID Acknowledgement Form, including signature, from each individual visitor at the start of the visit, scanning the signed form, and forwarding it via email to Kevin Kelliher (kxk84@psu.edu) once the visit is complete. Forms can be downloaded from the following link. https://hhd.psu.edu/sites/default/files/health-and-human-development/covid-19-response/health-and-human-development-covid-19-response-hhd-covid-acknowledgement-form.pdf Please direct any questions on the process to Kevin Kelliher (kxk84@psu.edu) or Ryan Golas (reg22@psu.edu).

Department/Unit*

1. If more than 3 visitors, please upload a spreadsheet with visitor names, locations (county, state, country) visitors are traveling from, and organizations visitors are associated with 2. Email or document confirming supervisor approval

Drag and drop files here or