Skip to main content Skip to main menu
UF Health University of Florida
Office of Graduate Education College of Medicine
support the department: make a gift
Student Affairs Overview

Care Concern Graduate Student Referral and Reporting

The Care Concern Referral for College of Medicine graduate students allows students, staff, faculty, and University of Florida community members to refer a student of concern.

This referral will be reviewed by a Student Affairs staff member during University business hours. If you believe this student is experiencing a mental health crisis and is in need of immediate assistance, or this is an emergency, please call the University of Florida Police Department at (352) 392-1111, or dial 911.

I understand that this form must NOT be used to report emergencies. Emergencies include students who are actively suicidal, homicidal, or in need of immediate follow-up. Please contact UFPD or dial 911 for emergencies and submit a Care Referral afterward.(Required)
 
Your Contact Information: (only referral source is required)

Student of Concern Information

Student Referral

Type of Concern

Safety Risk Concerns (Please select any that apply): Please contact the University of Florida Police Department at (352) 392-1111, local law enforcement at 911.
Academic Concerns (Please select any that apply):
Behavioral and Emotional Concerns (Please select any that apply):
Physical Concerns (Please select any that apply):
Basic needs (Please select any that apply):
Community & Belonging (Please select any that apply)
Miscellaneous concerns (Please select any that apply):
How would you prefer that a staff member from Student Affairs follow up with you?(Required)

Reporting Student Event

Emergency Services Response, please select any that occurred:

Supporting Documentation

Photos, video, email, and other supporting documents may be attached using the link provided after you submit this form.