Richland CARES

CARE Team Referral Form

Use this form to share a concern about a Richland student or staff member with our Richland College CARE Team. A member of the CARE Team will review this information Monday-Friday within 48 business hours. This form is not for emergency situations. In case of an emergency call 911 on a campus phone, or 972-860-4290 from a cell phone.

Please provide the following information about yourself, so that a team member can reach you if necessary. You may remain anonymous; however, we encourage you to share your name and contact information, so that we can follow up with you. Every effort will be made to keep your identity confidential.

Please submit any supporting (i.e.: student assignment(s), photos, writings, e-mail communication, and/or social media postings), by attaching them to an email and sending them to; or you can place them in an envelope addressed to "CARE Team/Confidential Documents" and deliver the envelope to the Richland College Counseling Center, located inside the Lakeside Resource Center, El Paso Hall room E082. Include identifying information to connect the envelope to this referral form.

Your Information
Person you are Referring Male

CONFIDENTIALITY NOTICE: This email message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential student and/or employee information. Unauthorized use and/or disclosure is prohibited under the federal Family Education Rights & Privacy Act (20 U.S.C. §1232g, 34 CFR Part 99, 19 TAC 247.2, Texas Government Code 552.023, Texas Education Code 21.355, 29 CFR 1630.14(b)(c)). If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. Please call the sender immediately or reply by email and destroy all copies of the original message, including attachments.

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