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CARE Team Referral Form


FYI for Emergency Reports


If this is an emergency that involves imminent risk of harm to oneself, please contact the 24/7 Crisis Line at 903.566.7254. You may also contact the University of Texas Police Department (UTPD) at 903.566.7300 or 911 for your local emergency response system outside the Tyler, Texas area.

For emergency cases involving imminent risk of harm to others, please contact UTPD at 903.566.7300 or 911 for your local emergency response system outside of the Tyler, Texas area.

CARE Team Referral Form Overview


The University of Texas at Tyler believes that if a student is to be successful academically, support must also be given on an emotional, social, physical, and intellectual basis. Because of this ideology, UT Tyler revamped its interdisciplinary Behavioral Intervention Team (BIT) to provide confidential assistance through what is now called the Campus Assessment, Response, and Education (CARE) Team. To learn more about the CARE Team, please visit the Office of Student Conduct and Intervention.

Case Review
Referrals are only reviewed during normal business hours (Mondays to Fridays, 8:00 a.m. to 5:00 p.m.). Any referrals submitted outside of business hours, on weekends, or during University-observed holidays will not be reviewed until the next business day. For assistance or consultation, please contact the Dean of Students Office at deanofstudents@uttyler.edu or 903.566.7406. To understand how to address a case prior to reporting, please view the What to Watch for/Levels of Concern link.

Resources
For students who are seeking resources, please view the Student Resources link for university and community resources available to you. For employees who are responding or addressing a case involving a student of concern, please review the Staff/Faculty Resources link. A PDF version of the resources provided by the University of Texas at Tyler can be found here.

If you need to report an incident regarding sexual assault, harassment, or misconduct, please submit a Title IX Report Form.

Please share with us your information

Urgency of this Report Definitions

  • FYI/For Your Record: Filing a report under this option will document a concerning pattern of behavior; however, you are requesting no further action. (Please note, if there are concerning signs of behavior, the Case Manager or his/her designee may have to intervene.)
  • Low: Filing a report under this option will document a concerning pattern of behavior, and you are requesting a low-level response.
  • Normal: Filing a report under this option will document a concerning pattern of behavior, which the CARE Case Manager will respond to. Reports filed under this typically include behavioral difficulty with an individual.
  • Elevated: Filing a report under this option will document a concerning pattern of behavior that requires assistance. Cases such as these typically include threats or a plan of action to harm to oneself or others.
  • Urgent: I am requesting an immediate response to this situation due to concerning factors.
 
Email address must be of a valid format.
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Student of Concern

Please list all individuals involved, including as many of the listed fields as you can provide. For individuals who are not affiliated with UT Tyler, please provide a Drivers License number in the block labeled "Student / Employee ID," if available. If you have listed your information above, you do not need to include your information below.

Involved party 1

Tell us a little more...

The CARE Team Referral Form can be used for self-referral or to report a concern/incident about the behavior of others. Upon receipt of the report, the CARE Team will conduct a preliminary investigation and take appropriate action.

Given the nature of these concerns, the Case Manager or CARE Team may not be able to offer information in regards to the needs and services addressed with Student(s) of Concerns. However, if you should have questions about the general process or how to provide additional support, please feel free to email the Dean of Students Office, at deanofstudents@uttyler.edu or 903.566.7406.

In regards to the Student of Concern(s) listed above, I am concerned about the following behaviors and issues (select all that apply):(Required)
You must make at least one selection.
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Have you addressed your concerns directly with the Student of Concern?(Required)
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Was the University of Texas Police Department or local law enforcement notified?(Required)
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Was anyone transported to jail?(Required)
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Was emergency medical transport required for the Student of Concern?(Required)
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Supporting Documentation

Please upload any supporting documents you may have regarding the Student of Concern and/or this incident. Contact the Dean of Students Office at dos@uttyler.edu or call 903.566.7406 if you have supporting documentation over the 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission