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Refer a Student in Distress - Care Services


BEFORE YOU BEGIN:

Please note submissions using this form will not be reviewed outside of regular business hours (M-F, 8am-5pm). If a student is experiencing a mental health-related crisis and you are worried about their safety, please call CAPS at (657) 278-3040 prior to completing this form.

 

If there is an immediate risk to health or safety, please call 911 or University Police at 657-278-2515. This form is NOT designed as an emergency response notification. 

 

If you are unsure the distressing behavior rises to the level of a call to University Police, please refer to the Welfare Check Guide. This form is not a Welfare Check Request.

 

If your concerns are regarding Sexual Misconduct, Sexual Harassment, Stalking, or Dating/Domestic Violence, please complete the Title IX and Gender Equity online form.

 

If you have information about possible conduct violations (such as hazing, bullying, alcohol, drugs, and disruption), please complete the Student Conduct Referral.

 

Care Services  may be needed when students experience distress that hinders them academically, emotionally, behaviorally, or physically. If you have already intervened but the student is still distressed, please complete a referral and our staff will respond within 1-3 business days. Please be patient as we process referrals in as timely a manner as possible. 

 

Thank you for sharing your concerns and helping maintain a healthy and safe CSUF campus community.

 

Reporter Information

Please provide your contact information so that we may follow up with you as needed.

 
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Student In Distress

Please provide name of the student in distress. Provide CWID and contact information if known.

Involved party 1

Information About the Concern

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Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
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