Student H1N1/ Influenza Like Illness (ILI) Notification System

Please use this form to report H1N1/ILI symptoms.

Completing the form will automatically send a notification to the following UST email accounts:

• Your professors/instructors for the current term
• Student Health Services
• Academic Counseling – Undergraduate
• Program Mailbox -- Graduate, Law & Professional Schools

A confirmation email will also be sent to your personal UST e-mail as a receipt and should be retained for record keeping purposes.
If you receive an error message when attempting to self-report please call (651) 962-7425 and leave your name and student ID on the voice-mail. Academic Counseling will notify your instructors and health services regarding your illness.

By completing the form I am reporting that I have Influenza Like Illness (ILI) defined as a fever equal or greater than 100° Fahrenheit (F) plus a cough or sore throat.

Based on the current recommendations of the Centers for Disease Control I agree to self-isolate, except to seek medical care, for at least 24 hours after fever has resolved, without the use of fever-reducing medicines .

I will not be in class during this time.  I understand that an e-mail will be sent to my instructors, however, I am responsible for the material presented in class.