Concern Report Form

A Concern Report Form can be used to report concerning student behavior or concerning information of a personal nature. Follow up from additional college staff is desirable/needed and the concern may include referral to outside agencies. The form is usually completed before any incident has occurred and is reviewed by the CARE team for action.

Concern Report Form

Person Reporting Concern Info
Concern Information
Date & Time of Concern *
Format: 2020-01-25 18:08
Please list all parties involved and any contact information obtainable.
Please list all witnesses and any contact information obtainable.
Concern Details
Give as much detail as possible.
Please describe injuries if any.