COVID-19 High Risk/Increased Risk Student Attestation Form

As Durham Tech continues transitioning back to on-campus operations, the College is working to create safe learning options for students, including those who are identified as high-risk by the CDC. The College will offer these students an opportunity to explore remote learning options, or other alternatives, if they cannot resume seated classroom instruction without increased risk to themselves or an immediate member of their household. If the student is not enrolled in any seated, hybrid, blended courses in the applicable term, there is no need to complete this form.

The CDC has identified those individuals who are at increased risk of severe illness from COVID-19, which includes:

  •     Older adults in their 50s, 60s, and 70s are at risk for severe illness from COVID-19. The greatest risk for severe illness from COVID-19 is among those aged 85 or older.
  •     People with underlying medical conditions including:     
    • Chronic kidney disease             
    • COPD (chronic obstructive pulmonary disease)
    • Immunocompromised stated (immune system) from solid organ transplant,     
    • Obesity (body mass index [BMI] of 30 or higher)        
    • Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies<        
    • Sickle cell disease       
    • Type 2 diabetes mellitus    

The CDC has also identified those individuals who might be at an increased risk for severe illness from COVID-19, which includes people with the following conditions:

  • Asthma (moderate-to-severe)
  • Cerebrovascular disease (affects blood vessels and blood supply to the brain)<
  • Cystic fibrosis>
  • Hypertension or high blood pressure
  • Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
  • Neurologic conditions, such as dementia
  • Liver disease
  • Pregnancy
  • Pulmonary fibrosis (having damaged or scarred lung tissues)
  • Smoking
  • Thalassemia (a type of blood disorder)
  • Type 1 diabetes mellitus

Students who believe they are or may be at increased risk for severe illness according to the CDC, which would necessitate an offer of remote learning options, may want to discuss their situation with an advisor prior to completing this form. Students who are identified by the CDC as needing to take extra precautions, or who have self-identified as high risk, may also complete this form. These students may request reasonable accommodations (which may or may not include remote learning options) under the Americans with Disabilities Act (ADA), as amended, and Section 504 of the 1973 Rehabilitation Act, by initiating the established accommodations request process. The College requests that students allow sufficient time for review of this attestation form and supporting documentation, and official notification of any required action. This form should be submitted at least 5 working days prior to the desired start of the applicable remote learning option/accommodation, or as soon as the student (or their immediate household member) is determined to be high risk.