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CARE Report Form

CONCERNED ABOUT A UNCP STUDENT? KNOW A STUDENT WHO MIGHT BENEFIT FROM ADDITIONAL SUPPORT OR RESOURCES?
The University of North Carolina at Pembroke seeks to foster a culture of caring and a climate of safety that requires the involvement of all members of the University community. The following CARE Report Form has been provided to encourage anyone (students, faculty, staff, family, and others) to refer a student who may be struggling with academic, personal, or emotional difficulties or who may be exhibiting concerning behavior.

Referred students will be contacted and offered guidance and assistance by the UNCP CARE Team. CARE Team Case Managers support students through challenges, connect them to appropriate campus and community resources, promote growth in self-advocacy, and empower students to reach desired goals.

BEFORE YOU BEGIN: If this is an emergency that involves imminent risk of harm to self or others, please contact UNCP Police and Public Safety at 910.521.6235 or by dialing 911 prior to filling out this referral form. CARE referrals are reviewed during normal business hours and are not monitored after hours, on weekends, or during official University holidays. While referrals from this form are reviewed by a variety of campus partners working to assist students and employees, it is NOT designed for emergency response situations.

If you have a concern about a UNCP Faculty or Staff Member, please email employee.concerns@uncp.edu or contact Dr. Nicolette Campos at 910-775-4341 or nicolette.campos@uncp.edu.

Thank you for taking the time to share your concerns and help UNCP maintain a healthy and safe campus environment.

Reporting Persons Contact Information

Please provide your name and contact information to allow us to call or email if we have additional questions regarding your report.

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Student of Concern's Information

Please provide as much information as possible about the student who is exhibiting concerning behavior.

Student Name

Banner ID Number (if known)

Student Phone Number (if known)

Student Email Address (if known)

Student Address (if known)

Tell Us About Your Concerns:

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report