CARES Intervention Report of Concern The CARES Team responds to non-immediate concerns and takes a proactive approach to discuss potential issues, intervene early, and provide support and behavioral response to students displaying varying levels of disruptive, disturbed, and/or distressed behaviors before they rise to the level of a crisis. Reporting Party's Information First Name *Last NameDate *What is your role at College of Alameda? *Select OneStudentFacultyProfessional StaffAdministratorEmail Address *Phone Number *Person of Concern InformationFirst NameLast NameStudent ID (if you do not have one leave blank)Threat to self or others *Threat to selfThreat to selfThreat to othersUnsure/InapplicableSelect *Select OneStudentEmployeeIncident Report Date of incident *Area of Concern *There are NO Concerning BehaviorsConcerning Eating BehaviorsDisturbing Writing or DiscussionExtreme Mood SwingsLoner/few or no close friendsPhysical Self HarmThreats (Direct or Veiled)Agressive BehaviorDating/Domestic ViolenceDisheveled AppearanceEmotional OutburstsMissing After Attempts to ContactSeeing/Hearing ThingsSuicidal Remarks/AttemptsUnusual Bruises,Cuts or AbrasionsBizarre/Disjointed ThoughtsDepression or Extreme SadnessExcessive AnxietyHomelessnessObsessively Suspicious/ParanoidSignificant Change in Appearance/BehaviorsTalking to SelfWithdrawl from Social GroupsPlease provide a detailed description of the incident/concern focusing on fact, including people involved (who, what, when, where, why, and how). *Do you want to remain anonymous? *YesNoPlease detail any action(s) that you have taken in response to this incident. If no action was taken, then type "none" in the text box below. *Please submit any supporting documents (email, photos, videos, etc).Choose FileNo file chosenDelete uploaded fileAcknowledgement and submission *I acknowledge that the information I provided in this report is accurate and truthful to the best of my knowledge.Send Message