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CARE Report Form


Please complete the following form to express concern for a student experiencing distress of an academic, health, safety, or financial nature. Please complete this form to the best of your abilities.

Note: Form submissions will be reviewed and addressed during business hours (Mon-Fri, 8am-5pm). 

If the student of concern is in crisis or there is an immediate threat of harm, violence, or substantial disruption, please call campus police or 911. 

 

Background Information

 
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Email address must be of a valid format.
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If unsure of incident date, enter date when you were made aware of the concern.
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If unsure of incident time, enter time when you were made aware of the concern.
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Student of Concern

Involved party 1

Questions

Please categorize your concern(s) for the individual (check all that apply):(Required)
You must make at least one selection.
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What actions have you taken, if any, to address your concern? (check all that apply)(Required)
You must make at least one selection.
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Is the individual aware that you are sharing your concern?(Required)
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Confirmation of Non-Urgent Nature of Report(Required)
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Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission