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CARE Form Impact


The CARE form should be used to report any behaviors of concern involving a Fairmont State University student, whether these behaviors occur inside or outside of the classroom setting. Please visit the Fairmont State University Crisis Policy regarding when to report a student in distress. Remember to always act with an abundance of caution and if you See Something, Say Something and Do Something.

Who should use this form?

Faculty, staff, students, family members or any person in the Fairmont State University Falcon Community who is concerned about a student. When the form is completed, someone from Student Health will reach out to the student, triage the situation, and follow up as appropriate. Be aware that anonymous reporting limits the effectiveness of dealing with concerning behavior. CARE Forms submitted after normal University business hours will be reviewed as soon as possible the next business day.

Reminder: Please call campus police
at 304-367-4357 or 911 if this is an EMERGENCY.

Crisis Response Protocol

Determine if the student is a danger to self, or others, or does the student need immediate assistance for any reason?


The students’ conduct is clearly reckless, disorderly, dangerous, or threatening. This includes self-harm or brandishing a weapon.


After speaking with campus police or 911, report concern by filling out the CARE form

I'm Not Sure

The student shows signs of distress, but I am not sure how serious this is. After interacting with the student, I feel uneasy and/or concerned about the situation.

During office hours, stay with the student and walk them to the Office of Student Health if they are willing.

If it is after-hours or the student is unwilling to go to the Office of Student Health, fill out a CARE form. Students can contact Valley Crisis Line if additional assistance is needed at 1-800-232-0020.


I am not concerned for the students’ immediate safety, but they are having significant academic and/or personal issues and could use support.

Fill out a CARE form which will be triaged by a member of the Office of Student Health, Wellness of Mind & Body.

Direct student to the Office of Student Health, Wellness of Mind & Body to set up counseling.

Person Making Referral
Person Being Referred
Tell Us Your Concerns
Nature of concern*
Have you addressed this concern with the student?*