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Counseling Resource Center - BART Concern

Concerning Behavior Report

Please use this form to report concerning behavior to CGTC's Behavior Assessment & Recommendation Team (BART). If someone is exhibiting behavior that is life-threatening, STOP and call 911 (8911 from an on-campus telephone) immediately, then submit this form after the threat has been contained.

Your contact information

First Name

Last Name

Which best describes your role at CGTC:

Please enter an 'other' value for this selection.

CGTC Student ID Number

Title

Phone Number

Email Address This question requires a valid email address.

Please tell us about the incident:

Date of incident This question requires a valid date format of MM/DD/YYYY.

calendar

Time of incident

Where did the incident take place?

The behavior that I witnessed was (check all that apply):

Odd or Eccentric
Concerning
Threatening To Me
Threatening to Someone Else
Threatening to Self
Other - Write In Please enter an 'other' value for this selection.

Was a report filed with the local Police Department or Sheriff's Office?

The incident involved:

Students
Faculty
Staff
Guests on campus
Other Please enter an 'other' value for this selection.
I don't know

Do you know the name(s) of the person(s) involved in the incident?

Please list the name(s) of everyone involved in the incident

Please provide a detailed description of the concerning behavior, including all relevant information.

Please upload any photos, videos, screenshots, etc... that you feel are relevant to this incident.

File: {{filename}} delete

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