Marian Cares Note

This reporting form should not be used to report emergencies. If you feel threatened, or are aware that someone is in extreme distress or at risk for harming themselves or others, please dial 911 immediately.

This form should be used to report non-emergency concerns about student well-being. The information you provide will be forwarded to the Marian University Cares Team. The committee provides a proactive, supportive, and coordinated response to student behaviors that may compromise the safety and well-being of the student and/or others.

Information submitted through this form constitutes an educational record and may be inspected by the student(s) identified in the report. If you have questions or would like to discuss your report before submitting it, please contact Marian Cares Chairs:

Severa Krueger

Jennifer Farvour

Background (Person Completing This Form)

MM slash DD slash YYYY

Individuals Involved

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide. For non-students, please list a Driver's License number if available.

Reason for Cares Note (Please check all that may apply)(Required)

Emergency Services Called?

Supporting Documents

Photos, video, email, and other supporting documents may be attached below. 10MB maximum file size. Attachments require time to upload, so please be patient after submitting this form.

Drop files here or
Max. file size: 2 GB.