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Report a Concern to the RUBIT

If you observe the behavior of a student, faculty or staff member that warrants concern, please complete and submit the Concern Report form below. By submitting this form, you will notify the Regent University Behavioral Intervention Team (RUBIT) for follow up purposes. Your submission will be handled with discretion and reviewed by RUBIT with the consideration of campus and personal safety in mind. Please complete each section of the form for accuracy of information and follow-up contact (if necessary). Thank you for your commitment to a safe campus and the well-being of those connected with Regent University.


Your Name:
Your Department/Title:
Your Phone:
Your Email Address:
RUBIT follow-up requested for:
Student/Employee Name:
Student/Employee ID# (if available):
Student/Employee Email (if available):
Reason for Concern:
(Please check all that apply.)
Odd/Eccentric Behavior
Aggressive Interaction
Threatening Communication
      (Mail or Verbal)
Self-Injurious Concern
Alcohol/Substance Abuse Concern
Hopeless/Depressed Demeanor
If Other, please explain:
Date of Incident/Noted Behavior:
Time of Incident:
Location of Incident:
Witnesses Present:
By submitting this document, you agree to consult with and/or provide additional information to the Regent University Behavioral Intervention Team (RUBIT) for the resolution of this matter, if needed. Forward all supporting documentation to . Should you have any questions, please call 757.352.4103 or email us at .
If you have an imminent concern that an individual will harm him/herself or others, please call Campus Police at 757.226.2075 immediately.
To verify that you are a real person submitting this form and not a robot please type the text in the image above in this box: