COVID Concern Form

This form is only meant for reporting a violation or a concern about following COVID-19 policies at NCC. If you wish to self-report about a positive result or potential exposure, please use the COVID-19 Report Form form.

NK-COVID Concern or Incident


Creating and sustaining a healthy and safe environment requires everyone’s help and commitment. The referral information on this page offers ways to identify and share a concern or to seek support. Please use this form to submit a concern for a student, faculty, or staff member in the NCC community who may not be following Norwalk Community College COVID-19 policies.
This form may be submitted anonymously.
It is important that you provide enough information to enable Management to provide appropriate and adequate investigation of your concern(s). Although this form may be submitted anonymously, please note that sometimes ability to address concern(s) is limited if there is no one to contact about the initial report where follow-up indicates a need for additional information. Concerns regarding faculty and staff will be directed to the COVID-19 Coordinator, while concerns about students will be sent to the Dean of Students.

Contact information

This section is optional. This form may be submitted anonymously.

Incident information

Please be as specific as possible.
Time of Incident
If known
(please be as specific as possible)
If not known, please leave as 'unknown'
What is the nature of your concern? (check all that apply) *
The more detailed the description, the better we will be able to follow-up.