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CARE Team Report Form

Who should use this form
This form is for the use of current students, faculty, or staff from Gateway Technical College. Please provide detailed information regarding the behavior of concern you are reporting. Once the form is received, a member of the CARE Team 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 a CARE Team report, please call Tammi Summers at 262-564-2538 or email summerst@gtc.edu.

Reporter Information

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Your full name:

Your Role:

Your phone number:

Your email address:

Email address must be of a valid format.

Campus location:

Level of concern(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location or Room #:

Involved Parties

Name

Select Gender

Role

ID Number

Phone number

Email address

Questions

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.

Email me a copy of this report

Reporter Information

Involved Parties

Questions

Supporting Documentation

Submission