Indicates required field
Individuals who are concerned about a student and are seeking assistance in supporting that student are encouraged to report their concerns through the following form.  Members of the CARE Team will in turn work with you to provide outreach and support to the student.  If you have a concern about a student, please know that confidentiality laws do not prevent you from reporting the concern.

IF THERE IS IMMEDIATE RISK TO LIFE OR PROPERTY please call 911.

Please complete the form as thoroughly as possible, this helps us support you and the student(s) as quickly as possible.
Background Information
Your full name:
Urgency of this report:
Location of Incident:
Student Concerning Behavior / Concern for Student
Please select the following concerns that have been observed.  Providing detailed description of the incident or concern will help the CARE Team better address your concern.
 
Academic Concerns (please select all that apply):
Emotional Concerns (please select all that apply):
Social-Cultural Concerns (please select all that apply):
Behavioral Concerns (please select all that apply):
Professional Concerns (please select all that apply):
Is the student aware you are reaching out to the CARE team for assistance and supporting them?
How can we best communicate back with you regarding your concern for this student?
Photos, video, email, and other supporting documents may be attached below.
Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif, jpg, png, pict, psd, txt, rtf, pdf, doc, docx, ppt, pptx, mov, mp3, wav, rar, svg, zip.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.