Behavior Intervention Team referral form

If there is an emergency or imminent threat to anyone’s personal safety, please call 911 and then notify Public Safety at 438-4555.

  • On-line submissions may be used for reports that do not require immediate (same-day) attention. Online referral forms will normally be checked Monday-Friday during business hours, but there may be periods during which online forms are not able to be responded to for 24-48 hours or more.
  • If immediate attention is required, please report the situation by phone instead of and/or in addition to an online report.
    • During business hours, call the Office of the Dean of Students at 360-438-4367
      or Public Safety at 360-438-4555.
    • During non-business hours, call Public Safety at 360-438-4555.
  • All reports to the Public Safety Office will be forwarded to one of the on-call professional staff.
  • If you have any questions about making the referral or would like to begin with a phone call or personal contact, please do so.
  • If there is no action required at the time, the concern will be noted and documented.

Please complete the following information. Required fields are marked with an asterisk (*).

You will be contacted by a BIT member for futher information. Please provide a personal contact number below.

Reporter's information

Please enter your phone number in the following format: xxx-xxx-xxxx.

Incident type(s)


Incident details
   



Name if known (first, middle, last) of the individual(s) involved & any known contact information.


Provide the names of any direct witness(es) to the incident or behavior.


Please provide a detailed description using specific, concise, and objective language.

Confirmation

Please check your information carefully for accuracy, and then click "Submit."