Behavioral Concern Report

Behavioral Concern Report

Fields marked with an * are required

Complete the following form to notify the BAC Behavioral Intervention Team (B.I.T.) of a student exhibiting behavior of concern seeking evaluation or intervention by the Behavioral Intervention Team.

NOTE: This form is not to be used to report an emergency. If this is a medical or psychological emergency, immediate threat of violence, substantial disruption, or a situation requiring immediate action, please contact Campus Security at 267.502 2424 or call 911.

Person Submitting Report:

Person Exhibiting Behavior of Concern:

Description of Behavior of Concern:

How frequently does the person exhibit the behavior you are concerned about?

You can choose for your identity to remain private, or select how involve you would like to be.

 

Thank you for taking the time to report this concern. We appreciate your willingness to come forward.