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Student Outreach & Support (SOS)
Referral Form


IF THERE IS IMMEDIATE RISK TO LIFE OR PROPERTY
Call 911 then 303-871-3000
(1-3000, if calling from a campus phone)

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If you are unsure if this is the correct office to refer or report to, please review this Referral Flow Chart 

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The Student Outreach & Support Staff reviews referrals on a daily basis, Monday-Friday, and outreach is made within 24-48 business hours to our students to learn how we may be able to support them in navigating some of the challenges they may be experiencing.
If you have questions or concerns please contact Student Outreach and Support at sos@du.edu. 

 

Background Information

 
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Involved Student Information

Please list the individuals for which you are submitting your concern, including as many of the listed fields as you can provide.

Involved party 1

Concerns and/or Observed Behavior

Please provide information below to the best of your knowledge. Please provide a detailed description of the incident or concern in the narrative box below. Please be professional, objective, accurate and factual.

If you are unsure of the nature of the concern, you can find more detailed description of indicators or signs that a student may be in need of support on this Support Indicators Resource Guide.

General Nature of Concern (check all that apply).(Required)
You must make at least one selection.
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Please share what other offices have been notified of this concern besides SOS, and resources offered, if any:(Required)
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Is the student aware a SOS Referral is being submitted on their behalf?(Required)
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Do you wish to remain anonymous if/when the student is contacted? **If it is your preference to remain anonymous, the outreach staff will make every effort to maintain anonymity. However, please know anonymity can never be guaranteed. Reports submitted through SOS Online Referral system are student records protected under the Family Educational Rights and Privacy Act (FERPA) privacy regulations. This includes students having access to their records. We or other university officials may need to follow up to gather additional information to help us most effectively support the student.(Required)
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Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission