If possible, please speak to your student about your concern before submitting this form. This conversation may provide you with additional context. In addition, you can inform them that you will be referring them to our office for support, which will assist with our outreach efforts.
Be as detailed as you can in describing your concern. The information you provide will help us understand how best to support the student. Please note that this form is for academic and personal concerns about students that may be impacting their performance and/or success in your course. If your concern relates to a student’s behavior in class, please use the Behavioral Intervention Form instead.
Do not submit multiple forms for the same concern. If you have referred a student, we will work diligently to contact them, meet, and address the issue with them. There is no need for you to submit a follow-up form unless a new concern arises.
We do not automatically send updates to referring faculty. If you are curious about a student you have referred and whether we have made contact, feel free to contact success@mica.edu and we would be happy to provide you with an update.