Student of Concern Form

AU Cares Student of Concern Form

Use this form to submit student behavior concerns and/or to report an incident. **The CARE Team is not tasked with responding to emergencies. If this is an emergency and you are in need of immediate assistance or consultation, contact Campus Safety at 864-231-2060.
Your full name:
Your position/title:
Your phone number:
Your email address:
Your physical address:
Name of Student of Concern
Student's Gender
Student's ID Number (if known)
Student's Year
Student's Birth Date (if known)

MonthDayYear
Student's Phone Number (if known)
Student's Email Address (if known)
Student's Residence Hall Assignment (if known)
Is this report a result of a specific incident or occurrence?

Specifics Regarding Incident

If you are submitting this report as the result of a specific incident please provide a details to enable the best follow up.
Choose the date and time of this incident

MonthDayYearHourMinutesAM/PM Option
Specific location of the incident:
Please provide a detailed description of the incident using specific concise, objective language.

AU Cares Student of Concern Form