Lower Columbia College: Behavioral Intervention Team (BIT)

* - mandatory
Your Information
Last Name * First Name * M.I:
Work Phone Number * Other Phone
Work Email Address *
Other Email Address
Student of Concern Information
Student ID
Student Last Name * First Name * M.I.
Student Phone Number
Student Email Address
Incident Information
Date of Incident * Time of Incident
Location of Incident

Please provide an objective, concise, detailed description in 10 sentences or less.
NOTE:
In writing your BIT referral, it is very important to only document observable behaviors and facts in the narrative. Avoid subjective feelings, diagnostic labels and/or derogatory information. This information could be viewed by others so please avoid inflammatory language. Example descriptions are listed in the Sample Comments.
Incident Description *