Notice of Concern

For students, staff, faculty, and administration to refer students to personnel who can assist them with academic, career, financial, housing, and personal matters. Please feel free to submit a Notice of Concern if you feel a Juniatian needs these additional services.

Date:

Name of person(s) involved:

Do you wish to remain anonymous?

Person making referral (your name):

Your email address (optional):

Please describe reasons for concerns (as specifically as possible, including dates and times):

Actions you have taken on behalf of person(s) involved:

Recommendation for further action:

Request for response:
Yes         No