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.
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 *