Emergency Planning & Violence Prevention

ACT Referral Form

If you are concerned about the health, well being, or safety of any individual on campus, you are encouraged to share your concerns or observations by contacting Health & Counseling Services, Student Services, Campus Police, Human Resources or by completing the ACT (Assessment & Care Team) referral form below.

Please, provide as much information as possible. If you do not know the name(s), provide any identifiable information. Referrals are sent to the Assessment & Care Team (ACT) members for initial review.



*Lewis Status (Relationship to Lewis): 
 Other/Unknown (Describe below)


Last Name:

First Name:


Security Password (Please type the word):

Your contact information will be kept confidential.

Helpful Resources

Stressed Students

Stressed Students: How You Can Help

Our college community is becoming increasingly aware of the amount of stress students are experiencing and its negative impact on their health and academic performance.

To address this concern, we have adopted an online training simulation that will assist you to better identify and refer these students to support services on campus. Lewis University highly recommends that you take this 45 minute course, which is already in use at hundreds of colleges and universities.

To take the course, follow the instructions below:

If you experience any technical difficulties, please email support@kognito.com


Caring for Our Community ACT 2014.

Video Presentation on Campus Violence.