Students have an option to give another individual authorization to disclose private mental health information. To do so, the student must complete the form below. Additional information about the option is described below.

In January 2016, the State of Illinois enacted a new law (Public Act 099-0278) that allows students the opportunity to authorize a person to contact for mental health emergencies. This individual would be outside the emergency contact person you provided when you enrolled in the university. This mental health emergency contact will be used should you experience a mental health crisis where you are determined to pose a clear danger to yourself or others.

If you choose to designate a mental health emergency contact, they should be over 18 years of age and able to make medical decisions on your behalf if you are unable to do so. Without a Designated Mental Health Contact on file and an emergency arises the university may use the general emergency contact on file. Please understand that under certain circumstances as allowed and/or required by law, university officials may contact family members or others in the event of an emergency without your expressed written consent. You have the right as a student to withdraw or revoke your Designated Mental Health Contact authorization by notifying the university in writing.

If you desire to designate a person that would receive certain private mental health information in such a situation, please complete the Mental Health Emergency Contact form and click "submit."