Campus Assessment Response and Evaluation (C.A.R.E) Team Referral Form

The members of the C.A.R.E. Team are available to the Manhattan School of Music community to accept notification and referrals of students, faculty, and staff who are in need of assistance and support. The purpose of this report is for you to be able to alert the Team of individuals whose actions and behaviors are of concern to you or the campus community. This report will be used to initiate assistance for the individual.

NOTE: If you have information about an MSM student who has been a victim of sexual harassment, gender-based harassment, sexual misconduct (including sexual assault), stalking, domestic violence or dating violence please use the Sexual Misconduct Report Form found here.

Would you be willing to share their names? If yes, please list them below:

Please comment on the concerning behavior below:

What, if anything, have you done to address this concern prior to the C.A.R.E. Team notification?

It is important to be true and correct in directing this information to the C.A.R.E. Team. Misrepresentation of information may result in disciplinary actions.

If you believe the individual or the community is in immediate danger, please contact the police department at 911.

I have read the information above and verify that the information I have provided is true and accurate to the best of my knowledge.

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Campus Assessment Response and Evaluation (C.A.R.E) Team Referral Form

Campus Assessment Response and Evaluation (C.A.R.E.) Team Referral Form