BEHAVIORAL INTERVENTION TEAM (BIT)
PERSON OF CONCERN REPORT
Please hand deliver printable form
to the UAM-CTC Public Safety Office, Room 106D, or in the Vice Chancellorís
Check Term: FALL SPRING
Person of Concern
What is the best way to contact this person?
Phone (If known):
The Office of Student Affairs seeks your help in identifying UAM community
members who are in need of guidance and support. The purpose of this report is
for you to be able to alert us to actions and behaviors that are causing
concern. This report will not be used to cause disciplinary action, but rather
to get help for the person.
Person Making Report: Faculty
If you believe the student or the community is in immediate danger, please
contact the Department of Public Safety at
870-364-6414 ext. 146.
Please indicate all that apply.
Mental Health Issues
Cyber Stalking and Harassment
Have others shared with you concerns about this person: YES
Please comment on the concerning behavior:
What, if anything, have you done to address this concern?
Do you wish to remain anonymous to the person of concern? Yes
(If you do wish to remain anonymous, the chairperson of the team may still
contact you for further information)
Evidence to suggest false or misleading reports with intent to defame the
character of another may result in disciplinary actions.
For UAM BIT Use Only
Student Address: _________________________________ E-mail:
_______________________ Phone Number: _____________________
Action Required Yes / No
Intervention recommended: __________________________________ Conducted by: