Wayne State University


WSU MRC Daily COVID Screener

 Before coming to the WSU MRI Core for any reason, it is WSU policy for the person to answer the questions below.
In order to protect the health of our community, WSU requires daily health screening by all individuals who wish to be physically present on campus.
Before coming to campus, you must first answer the questions below.

This form is valid only for today.

It is mandatory to all WSU Core members, WSU students and WSU employees to fill out and submit their WSU Campus Daily Screener form and forward a copy of their email confirmation to the MRC core at mrc3t@wayne.edu

Screening forms are valid only for the day they are requested.
You must complete a new form each day before you come to campus.

Have you experienced any of the following symptoms:
  • A new fever (100.4 F or higher) or a sense of having a fever?
  • A new cough that you cannot attribute to another health condition?
  • New shortness of breath that you cannot attribute to another health condition?
  • A new sore throat that you cannot attribute to another health condition?
  • New muscle aches that you cannot attribute to another health condition or that may have been caused by a specific activity, such as physical exercise?
  • New respiratory symptoms, such as sore throat, runny nose/nasal congestion or sneezing, that you cannot attribute to another health condition?
  • New chills or repeated shaking with chills that you cannot attribute to another health condition?
  • New loss of taste or smell that you cannot attribute to another health condition?


Do any of the below situations apply to you?:
  • Have you had close contact in the last 14 days with an individual diagnosed with COVID-19?
  • Have you traveled via airplane internationally in the last 14 days?
  • Have you had a COVID-19 test and are currently awaiting results?
  • Have you had a positive COVID-19 test in the past 10 days?


Are you fully vaccinated (two weeks after your second dose of the Pfizer or Moderna vaccine or two weeks after your single dose of the J&J vaccine)?




Privacy notice:The information you provide when filling out this screener will be shared with certain people.
  • If you answer “No” to questions 1, 2 and Yes or No to 3, then a message will be sent to the MR Core Technologists, stating that you are cleared to come to the MR Research Facility.
  • If you answer “Yes” to questions 1, 2, you are not cleared to come to the MR Research Facility. Please contact your health care provider or go to your nearest Urgent Care to get tested for COVID and reschedule your MRI appointment with the study coordinator.