Behavioral Intervention Referral Form

*required

Information Regarding Person of Concern


Details Regarding Incident

Please describe the incident using specific information. If you have any concerns or you do not feel comfortable entering the information below, please contact a member of the Behavioral Intervention Team. If this is an emergency, please dial 9-911 from a campus phone or 911 from any other phone.


Please provide us with your information so we can contact you regarding the incident, if you so choose.

Please fill in the field below.


WTCS New North