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.