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Threat Assessment Report of Concern

Identify the person about whom you are concerned
His or Her Name
Identify yourself
Reporter Name
By identifying yourself, the Threat Assessment Team will be able to more fully investigate and respond to your concerns. Without your identifying information, we may not have enough information to address the situation you have described. Anonymous reports will be pursued, but the ability of the Threat Assessment Team to respond may be limited. Thank you for your referral.
Nature of Report (Please provide as much information as you can)
Primary Nature
Format: mm/dd/yyyy; e.g. 09-01-2017
Observations of Appearance or Behavior
Grooming/Hygiene
Emotional Signs of Distress
Physical Signs of Distress
Behavior in Groups/Class
General Observations
If a person appears ready to harm themselves or others, please immediately call 911 and report.
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