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CARE Reporting Form


Each CARE report is an opportunity to help someone in need. Enter in as much information as you feel comfortable giving. Please know that the more details you give us to work with, the better we may be able to assist the individual.
Not unto ourselves alone are we born.
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IF THERE IS IMMEDIATE RISK TO LIFE OR PROPERTY CALL CAMPUS SAFETY

SALEM - 503-370-6911 or PORTLAND -  503-621-2061

 

 
Email address must be of a valid format.
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Student(s) of Concern

If you do not know a student's ID number, that is OK. Please provide the information that you have available for each involved person.

Involved party 1

Information

THE CONCERN HAS TO DO WITH ANY OF THE FOLLOWING BEHAVIORS: (Please mark all that apply.)(Required)
You must make at least one selection.
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WHAT IS YOUR RECOMMENDATION FOR THE STUDENT? This information will be communicated to the student.(Required)
You must make at least one selection.
This field is required.
ARE THERE OTHER (NON-ACADEMIC) CONCERNS THAT NEED ATTENTION?(Required)
You must make at least one selection.
IS THE INDIVIDUAL AWARE THAT A CARE REPORT IS BEING CREATED ON THEIR BEHALF?(Required)
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IF NECESSARY, MAY WE SHARE YOUR NAME WITH THE INDIVIDUAL?
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HOW WOULD YOU LIKE US TO FOLLOW UP WITH YOU?
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Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission