Behavioral Intervention Report of Concern The Behavioral Intervention Team (BIT) responds to non-immediate concerns and takes a proactive approach to discuss potential issues, intervene early, and provide support and behavioral response to students displaying varying levels of disruptive, disturbed, and/or distressed behaviors before they rise to the level of a crisis. Reporting Party's InformationName* First Last Date* Date Format: MM slash DD slash YYYY What is your role at College of Alameda?*Select OneStudentFacultyProfessional StaffAdministratorEmail Address*Phone Number*Person of Concern InformationName First Last Student ID (if you do not have one leave blank)Threat to self or others*Threat to selfThreat to othersUnsure/InapplicableStudent or Employee*Select OneStudentEmployeeIncident ReportDate of Incident* Date Format: MM slash DD slash YYYY Area of Concern*There are NO concerning behaviorsConcerning Eating BehaviorsDisturbing Writing or DiscussionExtreme Mood SwingsLoner/few or no close friendsPhysical Self HarmThreats (Direct or Veiled)Agressive BehaviorDating/Domestic ViolenceDisheveled AppearanceEmotional OutburstsMissing after attempts to contactSeeing/Hearing ThingsSuicidal Remarks/AttemptsUnusual Bruises, Cuts, or AbraisionsBizarre/Disjointed ThoughtsDepression or Extreme SadnessExcessive AnxietyHomelessnessObsessively Suspicious/ParanoidSignificant Change in Appearance/BehaviorsTalking to SelfWithdrawal from Social GroupsPlease provide a detailed description of the incident/concern focusing on fact, including people involved (who, what, when, where, why, and how).*Do you want to remain anonymous?*YesNoPlease detail any action(s) that you have taken in response to this incident. If no action was taken, then type "none" in the text box below.*Please submit any supporting documents (email, photos, videos, etc). Drop files here or Acknowledgment and Submission* I acknowledge that the information I provided in this report is accurate and truthful to the best of my knowledge.