Please select the reason you are concerned about this individual. You may select multiple reasons by holding down the Ctrl key when you click.
If you are a student referring another student, and do not know the ID#, please enter all 0s.
Please provide as much information as possible about the concern.
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If you have any supporting documentation regarding this concern, you may upload it here (For example, photos, emails, screen shots of text messages, etc.)
Example: one week, a month, etc.