When to Make a Referral

ACTIf 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 Student Wellness Center, Student Services, Campus Police, Human Resources or by completing the ACT (Assessment & Care Team) referral form below.

You may decide to report a concern if a person is:

  • Harmful to themselves or others
  • Making suicidal threats or gestures
  • Exhibiting alcohol or drug problems
  • Exhibiting a pattern of concerning, unusual or out of the ordinary behaviors or actions
  • Experiencing hospitalization for psychiatric, drug or alcohol problems.
  • Disruptive to the living or learning community
  • Withdrawing socially
  • Showing a decline in the quality of work
  • Showing bias, discriminating against or harassing others

This is not a complete list, but should give some idea of types of issues of concern. This list is meant to be a guideline and is not all inclusive. Please refer to the Identifying & Responding to Distressed or
Disruptive Persons
brochure or Z-Card for more specific guidelines.


Using the Success Coach Intervention form above, faculty can raise an academic alert regarding students in their courses. The students’ assigned Success Coach will reach out to the student and then share an update on outreach efforts with the faculty member. Questions regarding this process can be directed to Assistant Directors, Liseth Chavez (chaveli@lewisu.edu) and Stephanie Enervold-Macier (enervost@lewisu.edu).

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