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Student in Crisis Notification Form

Notification Form

If you believe that any student is in immediate danger of harm, please call 911 first, then APU’s Department of Campus Safety at (626) 815-3898.

Please use this form to notify Azusa Pacific University’s Care Team about a student whose situation has caused you concern, either for the student’s or others’ well-being. Please provide us with as much information as you are able. Submission of this form will result in intervention at a level determined appropriate by the members of the Care Team.

Student's Information






Your Information

Situation





* Required information