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Student Submitting Own Results

Use this form if you have gotten a COVID test outside of campus or if you have opted in to the at home COVID testing program.

The results of the test you upload must be dated for the week of the submission.

Deadline for submission is the Friday @ 4pm of that week.

Test results from at home tests can be uploaded.

Rapid Antigen Tests MUST process for 15 min before you upload results to this form. Failure to do so will result in your test being DENIED.

Please follow the correct format in order to be approved. Please include your name, date of test, time of test, a photo ID and your 800#/student ID#.

How to Submit your POSITIVE Test Results to MyHazen (use this form for NEGATIVE results only):

  • 1. Sign onto the MyHazen portal  
    2. Select the Upload  tab 
    3. Scroll down to Documents available to be uploaded  
    4. From the drop down, select COVID-19 test  results
    5. Upload your results (there are instructions on how to upload or fax files)  
           a. You may also fax your results to Hazen: (585) 395-2559  
           b. Contact Hazen staff if any questions: (585) 395-2414  

    • Name Name *
    • Must be 9 digits.   Currently Entered: 3 digits.
    • Please indicate residency. *
      Please indicate residency.
    • Indicate the purpose of submitting your own test result. *
      Indicate the purpose of submitting your own test result.
    • Date Of Test Date Of Test * / /
      Pick a date.
    • I understand that my test results must be dated the week that I am requesting this exemption. I understand that if my test does not meet the date requirements, I will need to participate in COVID-19 testing. *
      I understand that my test results must be dated the week that I am requesting this exemption. I understand that if my test does not meet the date requirements, I will need to participate in COVID-19 testing.
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