West Chester University of Pennsylvania Logo

CARE Support Services Referral Form


If this is an emergency, call Public Safety at 610-436-3311.

Referrals are reviewed during normal business hours (M-F, 8am-4pm) and are not monitored after hours, on weekends, or during official university holidays. Referrals using this form should NOT be used in situations requiring emergency response. The University strongly encourages those who want to file a report on behalf of themselves or someone else to identify themselves by name; however, anonymous reports will be accepted. Anonymous reporting may limit the action the CARE Team can take. The Office of the Assistant Vice President of Health & Wellness in conjunction with the CARE Team provides outreach to students when concerns for their health, welfare and safety are identified. 

If you have any questions, please visit the CARE website or contact us at care@wcupa.edu or 610-436-3089. 

If this is an academic concern, please use Navigate to share your academic concern with the Student Success and Engagement Team (SSET). 

Background Information

 
Enable additional features by logging in.
Learn more
How we should address you
Email address must be of a valid format.
This field is required.
This field is required.

Involved Parties

Involved party 1

Concerning Behavior Information

STUDENT CONCERNS
You must make at least one selection.
This field is required.
While we understand that every situation is different, we encourage that reporters connect with the student of concern prior to completing the CARE Referral form. Have you addressed your concerns directly with the student?(Required)
You must make at least one selection.
This field is required.
Was Public Safety notified?(Required)
You must make at least one selection.
What type of assistance are you seeking from CARE?(Required)
This field is required.
This field is required.
I understand this referral will be reviewed during business hours (M-F, 8am-4pm). Referrals are not monitored after hours, on weekends, or during official university holidays. If there is an immediate risk of harm to self or others, please call Public Safety at 610-436-3311 or dial 9-1-1.(Required)
This field is required.
I understand that after reviewing the referral, CARE Team will determine appropriate next steps, which may or may not include direct contact with the student of concern.(Required)
This field is required.

Supporting Documentation

Please do not submit any supporting documentation in HEIC format. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission