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

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

    Individual of Concern
    EmailPhone
    Reporter
    YesNo
    YesNo
    Report
    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.

     
     

     

    AcademicAdjustmentAlcohol/Drug AbuseDisrupting ClassroomEating IssuesFamily IssuesGrudgesHopelessnessSelf-InjuryStudent WritingsVerbal AggressionsWeaponsOther concerns

     
     

    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.

     
     

    YesNo

     

     

     

    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.