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Care and Concern Reporting Form

Important note: This form is not reviewed after-hours, on the weekends, or during university holidays or breaks.
If you need to report an emergency, call University Police at (239) 590-1900, or dial 911.

If you need to connect with Counseling & Psychological Services (CAPS) the may be reached at 239-590-7950. If you feel like you may be in danger of hurting yourself or others, call 911 or go to the nearest hospital. If you are an FGCU student in immediate distress outside of normal business hours (evenings, weekends, and holidays) who would like to speak with a mental health professional can call the CAPS help line: 239-745-EARS (3277).

If you are in crisis and would like to talk to someone outside of FGCU, you can call the Suicide Prevention Lifeline at 988 or text “HOME” to the Crisis Text Line at 741741. Both services are free, confidential, and available 24/7.

Who should use this form?
Community members, current students, faculty, or staff from Florida Gulf Coast University may use this form to report a concern. Please provide detailed information regarding the concern you are reporting. Once the form is received, Student Care Services will review the information and take appropriate action, which may or may not include contacting the student, you, and any others you have identified. If you have any questions related to completing this form, please call (239) 590-7900 or email CARE@fgcu.edu.

Student Care Services
Student Care Services works directly with undergraduate and graduate students to find solutions to academic, social and personal issues that may impact the potential for student success. We work with faculty, staff and students in identifying and addressing concerns BEFORE they reach a level of distress or involve a possible conduct violations.

Student Care Services also works with students to connect students with the relevant campus resources, outside agencies, and providers. We are available on a walk-in basis from 9:00am to 5:00 pm from Monday through Friday. In addition, we provide outreach to students taking into consideration their holistic needs and connect them with relevant resources across campus. Student Care Services continue to provide outreach as needed and appropriate to assure student success.

(Student Care Services is not a service to replace Counseling & Psychological Services, Academic Advising, University Police or other various student services.)

To report matters related to Student Conduct, please use the Conduct Incident Reporting Form found at: Conduct Incident Reporting Form

Background Information

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Date of behavior or incident(Required):

This field is required.

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When was this reported to you?

Time of behavior or incident:

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What time was this reported to you?

Location of behavior/incident(Required):

This field is required.

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Where/How was this reported

Specific location:

Student of Concern or Involved Parties

Please fill in as much information that is known at the time. Please make every effort to include the individuals name and FGCU ID, if possible.

Name or Organization

Select Gender

Select Role

ID Number (Ex: 815)

Phone number

Email address

Hall/Address

Reason(s) for Report

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.