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Student Care Inquiry


If you would like to consult with us prior to your submission, or need this form in a different accessible format, please call our office at 541-737-8748.

If this is an emergency, please call the Department of Public Safety & Oregon State Police at 541-737-7000 or Corvallis Police at 911.

Background Information

 
Email address must be of a valid format.
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If the concerns include any of the above, and you are an OSU employee, please also report to EOA.
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Persons Involved

Please enter all students who may require some follow up or care, including any distressed or distressing students, witnesses, roommates, classmates, or others. Please fill in whatever details you know about those involved, even if it is only their first names.

Involved party 1

Questions

Important: Information contained in this form submission may become part of a student's educational record. Please provide objective and concise information.

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What is your relationship to the student?(Required)
You must make at least one selection.
To build trust and transparency of our outreach, we request referrals to ask students for their permission to make a referral and identify if they are interested in outreach from our office. If you are hoping to consult on resources and supportive options, we can schedule a consultation with you instead. Is the student aware that you are connecting with Student Care and anticipating outreach?(Required)
You must make at least one selection.
How would you prefer we follow up with you?
You must make at least one selection.
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Supporting Documentation

If you have supporting documents, such as emails, photos, or scanned items, please upload those here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission