Campus Assessment Referral and Evaluation System (CARES Team)

To report a student whose behavior or emotional state is of concern to you, please fill out the form below.
Fields with a are required fields.

Online Reporting Form

Your Name

Your Title

Faculty/Staff

Faculty

Staff

Department

Office Phone

Format must be ##########

Cell Phone

Format must be ##########

College Email

Personal Email

Do you wish to remain anonymous to the student?

Yes

No

(If you do remain anonymous, a CARES Team Member may still contact you for further information.)

Name of the CSI student you are concerned about

If available, contact information for this person:

Specific description of your concern:

Date, time, and location of incident:

If appropriate, please list others who were involved and or observed the incident:

Other information you feel is important: