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Cares Report
Please leave contact information blank if you would like to remain anonymous; keep in mind that anonymous reporting may limit the ability of the Care Team to fully investigate the concern.
When to Use This Report
The purpose of this form is to give the SouthArk community the ability to report concerning, disruptive, alarming, or threatening behavior. This behavior may be an emotional disturbance, food insecurity, sexual or other misconduct, or any concern you have for a member of our community that you want a member of the team to reach out to. The Care Team will use the report to identify, assess, intervene, and respond to the situation. Although written notice is preferred via this form, if you have any problems or concerns with this form or you wish to make this report in person, please contact Vanessa Williams by phone at (870) 875-7235 or via email at vwilliams@southark.edu. (If an incident is currently a threat to physical safety, please report directly to the Department of Public Safety by dialing 999 or using a security phone if on campus; 870-866-9208 if off-campus.)
Your Name
First Name
Last Name
Your primary role at SouthArk
Please Select
Student
Faculty
Staff
Visitor
Your Phone Number
Please enter a valid phone number.
Your Email
example@southark.edu
Your Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Mailing Address (if different from physical address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please provide information related to your concern below.
Date you first noticed a change in the student or the date a concerning behavior occurred
*
-
Month
-
Day
Year
Date
Time of the event or precipitating behavior if applicable:
Location of the event (if a behavior of concern occurred:
Please Select
Off-campus
Online
Whitfield
Conference Center
Gym
Administration Building
Library
Student Center (Star Base 314)
Outer Space (outdoor area of Student Center)
Heritage Plaza
Tech Building
Health Sciences
McGehee
AMTC
Automotive/Engineering
Welding
Workforce
Brunson (Warren)
Confererence Center Parking Lot
Parking Lot between Admin and Library
Parking Lot in front of Student Center
Health Sciences Parking Lot
Tech Parking Lot
McGehee Parking Lot
AMTC Parking Lot
Workforce Parking Lot
Specific location the behavior occurred if applicable
Person of Concern and Witnesses
Involved Party
*
Please provide a description of your concern. The narrative should be as detailed as possible.
*
Attachments require time to upload, so please be patient after submitting this form.
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Important
If you are a victim and would like an investigation or assistance, you must sign below and provide your contact information above. Supportive measures will always be offered to victims regardless of a signature below or whether an investigation occurs.
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