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Student Concerns Intervention Team

» Student Concern Informational Report

Concerned about a student? Are they showing any behaviors of concern? The form below will be forwarded directly to the Senior Associate Dean of Students in the Dean of Students Office. The Senior Associate Dean will reach out to the student within 3-5 days (excluding holidays) of the submission of the report. We will discuss the concerns included in the report and work with the student and other key campus personnel to develop an appropriate plan to support that student’s success and ensure the safety and well-being of the campus community. 

NOTE  If your concern is related to an EMERGENCY where there may be an imminent risk to the safety of others (including imminent suicidal risks), the Student Concern Informational Report is not the appropriate way to let us know about your concern.  Please directly call one of the following offices:

Public Safety  - 714-997-6763 (all calls after regular business hours and on the weekends should be directed to Public Safety)

Dean of Students Office – 714-997-6721 (regular business hours)

Residence Life and First Year Experience – 714-997-6603 (regular business hours)

If you are dealing with a life-threatening emergency, call 911 immediately.  

Student Concern Information Form

* indicates a required field

Report Type (Check all that apply)
What is your status at the Chapman:
Please describe your level of concern (if your concern is severe or extreme, please contact Public Safety immediately at 714-997-6763 or 911 if appropriate).
Have you referred this student to any campus resources? Please check all that apply.