Student Care Form

The purpose of this form is to communicate any concerns that you have may have regarding the overall wellbeing of a PNWCC student. Concerns can be, but are not limited to: academic concerns, missing classes, changes in behavior, personal concerns, emotional concerns, family concerns, etc.
Please know that this form is not monitored 24/7. If this is an emergency, please contact 9-1-1 or suicide & crisis lifeline at 9-8-8 directly. Thank you!

Reporter Information

Your Name:

Relationship to student:

Your telephone number:

Your email address:

Student Of Concern

Name of Student

Reason For Concern

Please provide a description of your concern:

Please rate your level of concern for this student(s):

Please check "yes" to allow the student to see this care form during outreach. Not checking this box will keep the form private. If you have a question on how this form is used in the future, please contact the Dean of Students.

Yes

No

Privacy Policy- By checking "I consent" check box, you provide consent for Pacific Northwest Christian College to call you. We will never share your information.

Yes

Messaging Policy - By checking "I consent" check box, you provide consent to receive SMS, MMS, RCS, messages from Pacific Northwest Christian College. Message frequency may vary. Message and data rates may apply. Reply HELP for help or STOP to opt out. By checking, "I consent" checkbox you accept the terms and privacy policies of PNWCC.

Yes

Reporter Information

Student Of Concern

Reason For Concern

Scholarships

Resources

Faculty

Students