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Please use this form to report any student about whom you are concerned and explain why you are concerned. You may be contacted for clarifying information by a member of the Behavioral Intervention Team. Please understand that any follow up with the student of concern is confidential. IF YOU BELIEVE THE PERSON MAY HARM THEMSELVES OR OTHERS, PLEASE DO NOT USE THIS FORM.  Instead, call the Office of the Dean of Students at 207-741-5967 (during business hours) or Security at 207-741-5553 (after hours).  IF THIS IS AN EMERGENCY, CALL 911 AND SMCC SECURITY AT 207-741-5553 IMMEDIATELY.

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* Student First Name

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* Student Last Name

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* Student ID Number

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* Reporting Person Name

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* Reporting Person Contact Information

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* Please describe the nature of your concern in as much detail as possible.

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