View Site Map!
 AWC INDEX
a b c d e f g h i j k l m
n o p q r s t u v w x y z
Header Photo
Health Services
Web Advisor

SECTION LINKS

+ Health & Wellness 


QUICK LINKS

Icon Web Advisor WebAdvisor/Register
Icon Class Schedule Schedule of Classes
Academic Library Academic Library
Course Catalog Icon Course Catalog
Tuition Icon Tuition & Fees
Blackboard Icon Blackboard
Directory Icon Directory
Webmail Icon Webmail
Webmail Icon Help

Student Flu-Like Illness Tracking Form

It is necessary for Arizona Western College Health Services to track Flu-Like illness at all Campus and Learning Center locations to determine if our prevention strategies are adequate in minimizing infections.

Furthermore, it is important to provide the Yuma County Health Department, La Paz County Health department and the State of Arizona Health Department with all the necessary statistics on the epidemiological nature of the Flu virus. All information provided will remain as confidential as possible, while tracking this virus.

If you are experiencing symptoms of flu, please check the appropriate box(es) below:

  1. Enter your full name

  2. Enter your age:

  3. Enter your gender:

      
  4. I am experiencing the following Flu like symptoms:



  5. Date flu-like symptoms began:

  6. I am a student living "On Campus" at:





  7. I attend classes at the following AWC or NAU-Yuma locations(s):











Future Students | Current Students | Distance Education | Community Partners | AWC Foundation
About AWC | Admissions | Financial Aid | Online Services | Athletics | Student Life | Employment
 © 2014 Arizona Western College Disclaimers | EEOC | Site Map | Comments