十大电子游艺首页关怀队表格 | Lurleen B. 华勒士社区学院-十大电子游艺首页

提交十大电子游艺首页护理报告

Intervention and Referral Request

提供信息的人

第一个名字*

姓*

Your relationship to the person of concern*

电话号码*

街道地址

城市

状态

邮政编码

电子邮件*

关心的人

名字(关心的人)*

姓氏(有关人士)*

可能的昵称

性别*

大致年龄

If the person is in a class with you or you know of a class that they are taking, 请包括以下内容:

校园

建筑的名字

房间

日期

Time

紧急需求

Check all immediate needs that apply*

协助穿衣服

食物援助

住房援助

关注行为类型

Check all types of concerning behavior that apply*

虐待动物

Academic or workplace performance concerns

Change in mood, personality or behavior

Comments related to sleeping issues / nightmares

文化因素

要求

Difficulty controlling emotions

Direct threats toward an individual or individuals

Displays unprovoked anger, aggression or hostility

Excessive absenteeism / missing scheduled classes or appointments

Expressions of worry or anxiety

无用的表达

Farewell statements alluding to not ever seeing people again

绝望感

怀疑他人

赠送贵重物品

Inability to focus or concentrate

Inappropriate outburst or reactions

令人生畏的

Invades personal space of others

Makes unwanted physical contact

酒精饮料气味

对暴力的关注

全神贯注于火

交朋友的问题

Significant change in energy level

Significant change in personal hygiene or appearance

体重显著变化

Stares inappropriately at others

Suspected drug or alcohol abuse

Tardiness to class appointments

Tearfulness or repeated episodes of crying

自残威胁

Unusual or erratic performance, speech behaviors

不寻常的文字或图画

Visible Injuries - cuts, burns, etc.

Withdrawn - Complaints of fatigue

没有适用的

Check all categories that apply*

Committed sexual assault or abuse

破坏财产

伤害他人的幻想

痴迷于武器

纵火或纵火

Has suffered personal or financial loss

酒精/药物滥用史

History of planning a violent event

自杀未遂史

History of violent, reckless or antisocial behavior

Is not engaged in seeking treatment for diagnosed health condition

Offender - history of relationship/domestic violence

Other (Please provide details below)

Suffered childhood abuse or neglect

Suffered sexual assault or abuse

Victim - history of relationship/domestic violence

这些都不适用

Other - Please type your details below

指标 & Behaviors of Suspected Terrorists

Check all indicators and behaviors that apply*

Acquisition of Expertise - Attempts to obtain or conduct training in security concepts, military weapons or tactics for other than lawful purposes.

Aviation Activity - Learning to operate or operating an aircraft in a manner that poses a threat to harm people or property.

Breach/Attempted Intrusion - Unauthorized personnel; attempting to enter or actually entering secured area.

Cyberattack - Compromising or attempting to compromise or disrupt an organization's information technology infrastructure.

Eliciting Information- Questioning individuals at a level beyond mere curiosity about events, 设施, and related security procedures.

Expressed or Implied Threat - Communicating a spoken or written threat to commit a crime that will result in death of bodily injury to another person.

Expressed or Implied threat continued - or persons or to damage or compromise a facility.

Material Acquisition / Storage - Acquiring and/or storing unusual quantities of materials for use in unlawful activities.

Misrepresentation - and/or indentification misrepresent one's affiliation as a means of concealing possible illegal activity.

Misrepresentation - Presenting false information or misusing insignia, and documents.

Observation / Surveillance - Demonstrating unusual prolonged interest in a facility beyond casual or professional interest.

Photographing - Taking pictures of 设施 or buildings in an unusual manner that would be arouse suspicion in a reasonable person.

Recruiting / Financing - Providing direct financial support and/or assistance to a terrorist group.

测试 or Probing of Security - Deliberate interactions wiht people or 英斯达llations for the purpose of revealing security capabilities or weaknesses

Theft / Loss /Diversion - Stealing or diverting something associated with a facility/infrastructure for the purpose of committing an act of terrorism.

Weapon Collection / Discovery - Collection of unusual amounts of weapons, 弹药, 炸药, or toxic chemicals for other than lawful purposes.

没有适用的