Student of concern form

A student of concern form is a structured report that faculty, staff, or peers use to flag students who may be struggling academically, emotionally, or behaviorally. It captures identifying details, the reporter's role, the nature of the concern, specific observed behaviors, and any relevant context. It functions as the first step in getting a struggling student the right support, turning an informal observation into a documented referral.

Most students don’t ask for help. A concern form gives the people around them a way to act first, and a consistent reporting structure ensures the care team receives everything they need to respond—not just a name and a vague description. Use it to reduce response time, build a documented record for case management, and show students that the institution takes their wellbeing seriously.

Gather everything the care team needs to respond quickly:

• Student name, ID, and contact information
• Reporter's name, role, and department
• Type of concern (e.g., academic, behavioral, emotional, safety)
• Description of specific observed behaviors or incidents
• Date(s) and location of the observed concern
• Prior interactions or attempts to help
• Urgency level or recommended follow-up action

Anyone who observes a student in distress can submit a report—faculty, staff, advisors, resident assistants, or peers. While academic concerns like missed deadlines or failing grades typically come from instructors, behavioral or safety concerns can come from anyone in the campus community. Encourage a low barrier to reporting: it is always better to flag a concern that turns out to be minor, than to miss one that isn't.

Route submissions directly to a designated care team inbox or case management platform via Zapier, so nothing sits in a general inbox unnoticed. Assign a response window, such as 24 hours for general concerns or immediate escalation for safety flags. Communicate that standard to everyone using the form. Consistent follow-through builds trust in the reporting process and increases the likelihood that faculty and staff submit concerns early, before they escalate.