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Care and Concern Report

This form is NOT intended for life threatening emergency response.

If you are reporting an emergency that involves imminent risk of harm to self or others, please call 911 or campus security 269-470-6084 prior to completing this report.

Submitted Care and Concern Reports are processed during normal business hours and are not monitored after hours, on weekends, or during official college closures. Care and Concern Reports are reviewed by a member of the CARE Team. The CARE team is a group of diverse faculty and staff members who strive to support all students through challenges they may experience during their academic career.

Thank you for sharing your concerns about a student at Lake Michigan College. By sharing your concerns, you are supporting the goal of maintaining a healthy and safe campus community.

Tell Us About You:

Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(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:

Tell Us Who You Are Concerned About:

Person's Full Name

Pronouns

Living Environment

Student ID Number

DOB (DD-MM-YYYY)

Phone number

Email address

Tell Us About Your Concerns:

Have Supporting Documentation? Upload Below.

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.

Tell Us About You:

Tell Us Who You Are Concerned About:

Tell Us About Your Concerns:

Have Supporting Documentation? Upload Below.

Submission