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Student of Concern/Incident Report Form

In case of an emergency, please dial 911 or reach out to Campus Police at 410-386-8123. For concerns regarding threats to harm oneself or others, please contact 911 or Campus Police at 410-386-8123. If you have any concerns about a Carroll Community College student, kindly complete the Student of Concern & Incident Report Form. When filling out the form, please include your name, title, and contact details, and provide detailed information about the student concern or incident. While anonymous reports are accepted, we encourage you to provide your contact information for potential follow-up. Please note that Carroll Community College student records are safeguarded by the Family Educational Rights and Privacy Act (FERPA). Questions can be directed to studentcare@carrollcc.edu.

Additionally, if you suspect a violation of the Standards of Student Conduct, please submit the Student Conduct Incident Report form. This process is distinct for reporting violations of the Standards of Student Conduct.

Name(Required)
Email(Required)

Student Concern / Incident Report Details

What type of report are you submitting?
Are you reporting a Mental Health Concern?(Required)
A Mental Health Concern might be related to suicidal thoughts/feelings, isolation, grief, etc. Faculty/Staff with access to Starfish should raise a flag in Starfish instead of selecting this option. Students with Starfish access should raise a hand in Starfish instead.
Are you reporting a Human Services Assistance Concern?(Required)
A Human Services Assistance Concern might be related to food security, housing, transportation, etc. Faculty/Staff with access to Starfish should raise a flag in Starfish instead of selecting this option. Students with Starfish access should raise a hand in Starfish instead.
Are you reporting a Behavioral Concern?(Required)
A Behavioral Concern might be related to a decline in quality of academic work or performance, frequent absences from classes, social withdrawal, a concerning statement, etc. Behaviors of concern might be troubling, erratic, or indicative of distress, but they don’t necessarily violate the Code of Conduct. Faculty/Staff with access to Starfish should raise a flag in Starfish instead of selecting this option. Students with Starfish access should raise a hand in Starfish instead.
Students only: are you reporting a Conduct Incident?(Required)
A Conduct Incident might be related to disruptive behavior, failure to comply, facility/equipment abuse, or other behaviors that violate the Standards of Student Conduct. Faculty/Staff should not select this option. Faculty/Staff should use the Student Conduct Incident Report instead. Find a link to the Report at the Student Assistance Information for Faculty & Staff web page, under Integrity, in the Reporting Violations of the Standards of Student Conduct panel. Faculty and Staff can access the fillable form directly with this link: https://www.carrollcc.edu/wp-content/uploads/048-01-21-inf-reporting-a-violation-student-conduct-standards-frm-fillable.pdf
Students only: are you reporting a potential incidence of Academic Integrity Violation?(Required)
A potential incidence of Academic Integrity Violation might be related to cheating, dishonesty, plagiarism, or other behaviors that violate the Standards of Academic Honesty. Faculty/Staff should not select this option. Faculty and Staff should use the Canvas Workflow for Reporting a Violation of Academic Integrity instead. Find a link to the Workflow at the Student Assistance Information for Faculty & Staff web page, under Integrity, in the Reporting Violations of the Standards of Student Conduct panel. Faculty/Staff can access the Workflow directly with this link: https://carrollcc.instructure.com/courses/3393/modules/items/865162

Title IX

Any concerns related to Sexual Misconduct should be reported to titleix@carrollcc.edu which will go to the Title IX coordinator, Robert Brown. He will evaluate if the report falls under Title IX, if it does not he will ask the Behavioral Intervention Team to handle the case. For more information on Title IX or to report your concern please visit: https://www.carrollcc.edu/Title-IX/Title-IX-/-Sexual-Misconduct/