CARES Referral

Concern Type(s)*
Please select the reason you are concerned about this individual. You may select multiple reasons by holding down the Ctrl key when you click.
Student ID #*
If you are a student referring another student, and do not know the ID#, please enter all 0s.
State where student resides (this will help the team identify appropriate resources)*
Description*
Please provide as much information as possible about the concern.
Supporting Documents
Max. file size: 50 MB.

Accepted file types: doc, xls, pdf, gif, jpg, png, Max. file size: 256 MB.
If you have any supporting documentation regarding this concern, you may upload it here (For example, photos, emails, screen shots of text messages, etc.)
Does the student of concern have a trusting relationship with at least one person?*
How long have you been worried about this student?*
Example: one week, a month, etc.
Have you discussed this concern with the student?*
- Yes
- No
Is the student aware you are submitting a CARES referral?*
- Yes
- No
Your Name*
First Last
Your Email*
Phone*
What is your relationship to the Student of Concern?
How can the CARES Team best assist you?*
- I need resources.
- I have the resources I need, I just want the team to be aware.
- I would like to talk through this situation with a CARES team member.
Consent*
I understand this referral will be submitted to a system that is not monitored 24/7. If this is an emergency situation, I will call 911.
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