Concern About Student Well-Being

Concern About Student Well-Being

Early Alert Form
If you think a student is in imminent danger of harming him-/herself or others, call 911. A resource for the student and you is the Suicide Prevention Lifeline.

Call the Suicide Prevention Lifeline at 1-800-273-8255 or go to https://suicidepreventionlifeline.org/ to chat live with someone.

Please refer to the Counseling Services webpage on the PNWU website for additional counseling and support resources.

Please use this form to submit concerns you have about a student's well-being that do not involve imminent danger.

If you have concerns about student misconduct or lack of professionalism, please use the jotform at this link: https://www.jotform.com/build/201387048089057
Name of Student About Whom You are Concerned

First NameLast Name
Describe your concerns
Examples: Behaviors of concern, severity, duration, others affected, living situation
Have you discussed your concerns with the other person?

YesNo
If yes, what was the outcome?
If no, why not?
What do you hope PNWU can do to assist you and/or the other student?
We strongly encourage you to include your name and email contact so we can follow up with you to get additional information and/or to update you (to the degree possible) on any actions taken.

Your name will remain confidential to the extent possible.
Your Name (Optional)

First NameLast Name
Email (Optional)
example@example.com
Should be Empty: