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Student of Concern Referral Form

Student of Concern Report

Thank you for taking time to complete the Honors Student of Concern Report. Please complete as much information as is known. This report will then be forwarded to the Associate Dean (only) and reviewed for appropriate action. Please be aware that a member of the Honors College will likely reach out to the student to offer support and assistance. Should you wish for this not to occur, please be very clear about this in your report. However, due to the potential health and safety risk, there may be an obligation to follow up with the student. Information from the report may also be shared with the student. Someone from our staff may reach out to you to gain additional information. We wish to partner with you to support the student's academic and personal success in the least intrusive method appropriate to the nature of the concern. Details may not be able to be shared out of respect for the student's privacy and you, therefore, may not be aware of the outcome, but know that each and every submission will receive our attention.
  • Please be as detailed as possible in answering the following questions. Please note that this report is not intended to initiate a conduct process. It is solely focused on responding to concerning behavior and providing help.