Public CARE Report

Please take a few minutes to complete this Care Report so that we may respond appropriately. Faculty and Staff are encouraged to complete this form for any student for whom they are concerned. This form can be filled out for a concern that is an academic concern or any other issue that may be affecting a student's ability to succeed.

If you have any questions about this form, please contact the Office of Student Affairs at studentaffairs@uarts.edu or (215) 717-6617.
* indicates a required field

Date/Time/Semester/Year

  
What was the approximate time that the incident occurred or was brought to your attention?
   
SemesterRequired

CareNetwork Report

Please provide your full name (First_Name Last_Name)
Please provide your email address so that we can contact you if we have follow up questions about this report.
Please provide your phone number so that we can contact you if we have follow up questions about this report.
Report Type(s)Required

Please select only one Report Type at a time. If you have multiple concerns, please submit a separate report for each Report Type.

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Parties Involved

Please complete ONE form PER student.
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Please list names and contact information (if available) for all witnesses to this situation.

For Academic Concern Reports ONLY

Required field. If this report is not related to a course, please type "000" or any number here.

Required field.  Is this report is not related to a course, please type "0" or any number here.

Required field. If this report is not related to a course, please type "None" or "NA" here.

Reason for ConcernRequired
Required field. If this report is not related an Academic Concern, please select "Not Applicable"
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If necessary
  
If necessary
  
Tutoring RecommendedRequired
Recommendation for Withdraw (the withdrawal period ends April 1)Required

Concern Details

Please provide detailed information for staff to follow up. The content provided in the Description field will not be shared with the student.

File Attachments

Attach documents/Upload

Location

Optional for Academic Concern Reports
Location

Where did the situation occur?

If applicable, please provide any additional location details (for example: in the 3rd floor lobby).