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Auburn Cares Referral Form


Auburn University students, faculty, staff, and others are encouraged to refer students who are struggling with academic, personal, or emotional difficulties or who may be exhibiting hostile, worrisome, or other concerning behavior.  Students can also refer themselves for support. We will evaluate the report during normal business hours and determine the type of follow-up necessary to address the concerns.

If this is an emergency that requires immediate assistance, please call 911.

If the incident involves sexual or relationship violence, please complete this online Safe Harbor referral form instead or call 334-844-7233 to refer the student to a confidential advocate for support.

Reporting Party Information

The Auburn Cares office will use your contact information to follow up with you regarding this referral and any additional questions we may have.

 
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Please contact 911 or campus police for all imminent concerns. Pick one option below:
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Student(s) of Concern

Please provide identifying information about the student(s)/person(s) of concern. You may also add information about additional witnesses, etc. When considering the roles of individuals involved, please use the following definitions as a guide:

  • Alleged: Individual alleged to have engaged in conduct that violates policy, or has impacted another party.  
  • Impacted Party: Individual who has been impacted by the behaviors of the Alleged; the individual to whom the misconduct was directed.
  • Person of Concern: Someone who may need support dealing with a crisis and/or concern, or the subject who is a concern for the reporter. There is not enough information about this individual to indicate they are alleged to have violated policy. 
  • Witness: Someone who can provide information about the incident or may have been indirectly impacted by misconduct. A witness is not alleged to have engaged in a potential policy violation or behavior that has impacted another person.
Involved party 1

Concerning Behavior Information

Based on the nature of this report check all issues of concern that may apply:

Disruptive Classroom Behaviors:
You must make at least one selection.
Concerns for General Mental Health or Well-being:
You must make at least one selection.
Threatening Behaviors:
You must make at least one selection.
Suicidal Behaviors:
You must make at least one selection.
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Have you talked to or corresponded with the student regarding your concerns?(Required)
You must make at least one selection.
Does the behavior seem to be getting worse or more frequent?(Required)
You must make at least one selection.
Do you wish to remain anonymous if/when the student is contacted? ***If it is your preference to remain anonymous, the Division of Student Affairs Case Manager will make every effort to maintain anonymity. However, please know that anonymity can never been guaranteed.(Required)
You must make at least one selection.
What actions would you like the case manager take in this case?(Required)
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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