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Behavioral Intervention Incident Report


BIRT addresses student behavioral concerns that are inconsistent with the College’s mission. The members of this team act with a common purpose to address critical student behavioral or mental health concerns through review of situations/incidents, information gathering and sharing, and providing recommendations to ensure the safety and educational success of the student. The BIRT does not replace other classroom management or disciplinary processes nor does it address student behaviors that require immediate health, police or mental health attention.

The success of this process hinges on the College’s commitment to reporting concerns about potential threat of violence or concerning behavior.

For more information please visit BIRT Page

Background Information

 
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Faculty, Staff, Student, Other
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Involved Parties

Involved party 1

Information Regading Concern

Confirmation of non-urgent nature of report: I understand that this report will be received during normal business hours (Monday-Friday). For urgent concerns, call Campus Safety & Security at 239-489-9203 or call 911.(Required)
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Academic concerns: Select all that apply
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Physical Behaviors: Select all that apply
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Emotional Behaviors: Select all that apply
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Threatening Behaviors: Select all that apply
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Have you talked to or corresponded with this student about your concern?
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While we do our best to keep reports confidential, at times it is necessary to identify the reporting party. If necessary, may we share your name with the student?
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Please indicate in any of the following actions were taken as a result of the concerns you have described:
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What has been the best method of communicating with the student?
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What is the purpose of this report?(Required)
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Supporting Documentation

Photos, emails, 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