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UNHS maintenance work request
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* Indicates required question
Your Name
*
Your answer
Your Phone number or extension
Your answer
Location of the problem
*
Blanding Old BFP
Blanding Main Clinic
Blanding Dental
Gentle Ironhawk Shelter
Navajo Mountain clinic
Monument Valley Clinic
MCC EMS building
MCC New clinic
MCC old campus
Monticello Dental
Housing
Other:
Problem Type
*
Cleaning
Furniture
General Repair
Heat/AC
Lighting
Pests
Plumbing
Resupply
Security
Other:
Describe the problem. Use precise location, such as room number, building, and location.
Your answer
Priority
*
Very high
1
2
3
4
5
Very low
Preferred Completion Date
MM
/
DD
/
YYYY
Email address
Your answer
Submit
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