Public CARE Referral
Thank you for letting us know that you are concerned. This referral will be reviewed within one business day and you may be contacted to provide additional information. If you have a concern about an individual that you believe requires immediate attention, please contact Campus Police at 252-943-8721.
Your Name
First Name
Last Name
Your Email Address
example@example.com
Your Phone Number
Please enter a valid phone number.
Your Affiliation with BCCC
*
Please Select
Faculty
Staff
Student
Self (I am submitting a CARE form for myself)
Parent/Family Member
Other
Referral Type (Select one)
*
Student
Faculty
Staff
Unknown
Name of individual you are concerned about:
*
Does the individual know you are submitting this CARE form?
*
Yes
No
Please share your concerns and/or observations below.
*
What steps have you taken, if any, to address concerns?
*
(e.g. email/talked with student regarding my concern, contacted other campus offices, spoke with other college officials, etc.)
Please list any additional information below.
Is there any additional information you would like to provide?
Please verify that you are human
*
Submit
Should be Empty: