Illness Self-Report Form
If you are experiencing illness symptoms please complete the following form.

Once received you will be contacted by a member of the Student Life Team to answer questions you may have about resources available to you during your illness.

If it is after business hours, please contact the Emergency On-Call Residence Life Staff at 406.698.8777.
Email address *
First and Last Name *
Your answer
Cell Phone Number *
Your answer
Where do you reside? *
I am *
Other information:
Your answer
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