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Food Allergies and Sensitivities
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Contact
Food Allergies and Sensitivities Form
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Please choose your allergy/ies from the list below
*
Fish
Shellfish
Tree Nuts
Peanuts
Dairy
Eggs
Soy
Wheat
Other, please explain
*
How severe is your allergy?
*
What triggers your allergy? E.g. ingestion, inhaling, contact, etc.
*
Do you wear a medic alert bracelet?
*
Yes
No
Do you carry an epi pen?
*
Yes
No
Is there anything else we should know about your allergy?
*
Submit
Home
Locations & Menus
Olewine Dining Commons
Hollee's Cafe
Bennee's Bistro
Meal Plans
Residential Hall Plans
Commuter/Faculty Meal Plans
Catering
ABOUT
Food Allergies and Sensitivities
Work on Campus
Contact