UMPQUA COMMUNITY COLLEGE
STUDENT OF CONCERN/CARES TEAM
If you think this is an emergency, call 911!
For UCC Campus Security, call 541-440-7777
This form is not designed as an emergency response. Please be aware that this form will only be
read during normal business hours, Monday-Friday, 8:00 a.m. – 4:30 pm.
If you have a security concern or safety concern please submit a report through security here:
If the student’s behavior needs to be addressed due to a Student Code of Conduct Violation
please complete the following form located: Student Conduct Incident Report Form
Student of Concern Referral
Umpqua Community College is committed to the health and safety of all members of our
community. To safeguard our community, UCC’s CARES (Care Assess Respond Evaluate Support)
team has developed a reporting system to share appropriate information so students can
receive or stay connected to the academic support and student wellness services they need.
This referral system is one element of a safe and supportive campus community.
What happens once this form is filled out?
Email this form to the Life Coach at email@example.com if you would like the
student to be contacted quickly with potential campus and community resources –OR- if you
would like to submit the form to the CARES team.
Once this form has been submitted, the Life Coach or another CARES Team Member may
contact the reporting party for additional information prior to contacting the student. Once the
necessary information has been gathered, a staff member may reach out to the student (this is
determined on a case by case basis). During this contact, the situation will be assessed, students
may be offered services, are provided with appropriate resources and referrals, and may be
offered additional follow-up. Some referrals require additional attention. Based on the
student’s behaviors, those referrals will be discussed with the CARES Team, where additional
recommendations may be made.
Please Complete the Student of Concern Form on the Next Three Pages