Campus Safety Concern/Intervention Form

Safety Concern/Intervention Form

Please complete the following form to report a safety concern to the Northwest Shoals Community College Threat Assessment/Behavioral Intervention team. IF THIS IS AN EMERGENCY, DO NOT USE THIS FORM. CALL 911.

Additionally, HELPline offers 24-hour crisis counseling and can be reached at 256-716-1000 or 1-800-691-8426.

All reports to the Northwest Shoals Threat Assessment/Behavioral Intervention team will trigger an immediate email confirmation. A personal email from a threat assessment/behavioral intervention team will follow once an initial review of the report has been completed.

Campus Security may be contacted directly at 256-627-1526 for the Shoals campus and 256-417-4731 on the Phil Campbell campus.

Please describe the threat, including names, events, locations, etc:(Required)

Date situation or threat occurred(Required)

Approximate time situation or threat occurred(Required)

Northwest Shoals campus location associated with the threat:(Required)

Phil Campbell campus

Shoals campus

Your full name(Required)

First Last

Email(Required)

Your status at the College(Required)

Student

Faculty

Staff

Other

Please provide method(s) for us to contact you: (For example, please leave any combination of your home phone, cell phone, multiple email addresses, etc.)(Required)

Enroll for the Spring Semester. Classes begin January 8.

Safety Concern/Intervention Form

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