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Student Support Team:
Student of Concern Form


Please note that this form is not to be used for emergencies. 
All Student of Concern forms are routed daily through the Student Support Team (SST) Case Managers during the regular business week. In case of an emergency or the need for immediate assistance, please call 911 OR Campus Police at 941-487-4210.

If this is purely an academic concern, please use the Academic Referral Form on the myncf portal.


Why Document? This form is for use by NCF students, faculty, and staff. Please provide detailed information regarding the concern you are reporting. Once the form is received, a SST member will review the information and take appropriate action, which may or may not include contacting the student, you, or any witnesses you have identified. Our goal is to help students proactively address individual challenges that may hinder their success at New College of Florida and connect them with the appropriate resources.

Confidentiality of Reporters: The SST will take reasonable steps to maintain the privacy of those who complete a Student of Concern Report if requested. If the circumstances don’t allow privacy to be maintained, this will be discussed with the person making the referral prior to disclosure to the student, if possible.SST operates under the confidentiality parameters of Family Educational Rights and Privacy Act (FERPA) and the SST will take reasonable steps to maintain the privacy of students who are submitted to SST.

Confidentiality of Students Submitted: SST operates under the confidentiality parameters of FERPA and the SST will take reasonable steps to maintain the privacy of students who are submitted to SST. The SST will take reasonable steps to maintain the privacy of students who are submitted to SST. Some circumstances do not allow SST to maintain such privacy, such as threats of harm to self or harm to others which require that other systems of support be involved to help with safety concerns.

Please Note: All Student of Concern forms are routed daily through the SST Case Managers during the regular business week. The Student of Concern Form is for information-gathering purposes only and is not meant to be utilized as an emergency contact. If you have any questions regarding the form or have additional updates or concerns, please email the Student Support Team at StudentSupportTeam@ncf.edu. 

 

Background Information

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Or your affiliation to the student of concern
Email address must be of a valid format.
This field is required.
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Primary Nature of Concern
This field is required.
This field is required.
This field is required.

Involved Student Information

Please list the individuals for which you are submitting your concern, including as many of the listed fields as you can provide.

Involved party 1

Information Regarding Concern

This field is required.
I am concerned about the following behaviors (check all that apply):
You must make at least one selection.
This concern may be a result of bias or discrimination based on ability, age, class/ socioeconomic status, ethnicity, gender/ gender expression, nationality, race, religion, sex, sexual orientation, or another identity.(Required)
This field is required.
Have you addressed the concern directly with the individual?(Required)
This field is required.
This field is required.
Are you aware of any support services the individual is currently receiving?(Required)
This field is required.
This field is required.
Is the student aware that the Student Support Team has been notified on their behalf?(Required)
This field is required.
If necessary, may we share your name with the student of concern?(Required)
This field is required.
This field is required.

Supporting Documentation

Photos, videos, emails, and other supporting documents may be attached below. 1GB maximum total size. Please be patient after submitting the form, as attachments require time to upload. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission