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Student Concerns Reporting Form


For urgent or emergency situations, please contact Lehigh University Police at 610.758.4200 immediately, rather than submitting this form.

This form is to report concerning student behaviors, situations, or incidents that might require additional attention from the Dean of Students Office. The information provided in this form will be used to determine appropriate modes of monitoring and intervention. For more information about the Dean of Students Offices, please visit our website at: http://studentaffairs.lehigh.edu/dos


Please note that this form is not to be used for Section 3 reporting. Section 3's should be reported using this form: http://lehigh.edu/go/section3.

Reporter Information

Please provide your information so that we can follow up with you as needed.

 
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Involved Parties

Involved party 1

Questions

Please provide the following information as completely as possible so that we can act appropriately.

I have the following concerns about this student (check all that apply):(Required)
You must make at least one selection.
This field is required.
Have you addressed your concerns directly with the individual?
You must make at least one selection.
This field is required.
Are you aware of any services the student is receiving that relate to your concerns?(Required)
This field is required.
This field is required.
Is this student aware that this report is being submitted?(Required)
This field is required.
This field is required.

Supporting Documentation

Please upload any supporting documentation that you think is relevant (e.g., texts, email messages, pictures, course work). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission