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Submit a JeffCARE Report

JeffCare Intervention and Referral Request

Campus Security/Behavioral Care Team Form

  • Person Providing Information

  • The Person of Concern Information

  • If the person is in a class with you or you know of a class that they are taking, please include the following:

  • MM slash DD slash YYYY
  • :
  • Immediate Needs


  • Please indicate selections from the relevant category/categories. Circumstances associated with the person of concern that have been reported or known to you personally.

  • Indicators & Behaviors of Suspected Terrorists

  • This field is for validation purposes and should be left unchanged.