Student Support Request and Referral
To request assistance from the Dean of Students Office for yourself or someone else, please complete the following form by filling in the requested information. If you have any questions after completing the report form, feel free to contact the Dean of Students Office at 413-545-2684.
Please be aware that any time you record information about a student in an email, note, recording, or this referral form, the information becomes part of the student’s protected education record. Such information should be presented in a professional manner.

Please note: the Dean of Students Office’s ability to provide information back to the original reporter is shaped by University privacy policies and the federal Family Educational Rights and Privacy Act (FERPA). The “need to know” standard permits the staff to share confidential information regarding students with those who need the information in order to perform effectively in their jobs. If you are not directly involved in follow-up actions but have questions about the nature of the University’s response, please contact the Dean of Students Office.
When is it appropriate to request assistance from the Dean of Students Office?
The Dean of Students Office staff focuses on assisting students with personal or academic challenges. Examples of various challenges students may be navigating are provided below.
Academic
- If you have concerns related to course engagement, such as a student was previously engaged and abruptly stops attending classes, stops engaging with a course platform (LMS), and/or is unresponsive to academic outreach.
- If you are the course instructor and have concerns that are primarily about course performance, such as low grades, multiple missing assignments, or a student has never attended class, please submit a referral via Academic Alert.
- If you are an advisor with course performance concerns about a student, you can refer them to resources such as the Learning Resource Center, Success Toolkit Series, and CMass Success Coaching, Navigate. If you feel a referral to one of those resources is not appropriate given the student’s needs, please contact the Academic Dean in your school/college for support.
Campus/Social:
If you notice a student has expressed severe homesickness, reported serious roommate issues, or similar situation.
Medical:
If you notice a student has lost a dramatic amount of weight, has left campus for surgery or treatment, reported a medical condition of concern, or similar situation.
Mental Health:
If a student has become withdrawn, has begun to exhibit behavior you find concerning, has reported acute anxiety, submits an assignment with troubling content, or similar situation.
Personal:
If you notice a student reports a close friend or family member has died, reports a parent has recently become very ill, homeless, or reports other personal/family information.
Other Examples Would Include:
- Difficulty Transitioning to College Life
- Not Sure Where to Access Help
- Need to Access Multiple Campus Resources
- Basic Needs Resources
- Financial Struggles/Homelessness
- Missing Classes due to a personal/family situation; Significantly Behind in Coursework
- Injury or Illness
- Experiencing Depression, Anxiety, Panic and/or Other General Mental Health Concerns
- Victim of Bullying
- Alcohol or Drug Abuse
- Eating or Exercise Disorder
What information should I include in the description?
Reports are reviewed by the Dean of Students Office during regular business hours Monday – Friday, 8:30 a.m. – 5:00 p.m. The staff will determine the most appropriate action, make the necessary referrals, and provide support. In order to ensure that the concern is shared with staff from appropriate offices (University Health Services (UHS), Center for Counseling and Psychological Health (CCPH), Center for Women and Community (CWC), etc.) the Dean of Students Office staff will benefit from the most complete description.
Your description should include examples of observed behaviors or details of concerning interactions, including the names of others who may have witnessed or been affected by the situation:
- Copies of texts or emails, or any other documentation you can provide.
- It is also helpful to describe any steps you have already taken to address your concerns:
- Conversations you have had with the student
- Conversations with the student’s advisor or mentor
- Conversations you've had with another staff member to express your concern
Dean of Students Office Resources
The Dean of Students Office participates in the University's on call system alongside UMass Police Department (UMPD), Residential Life, University Health Services (UHS), and the Center for Counseling and Psychological Health (CCPH).
If you are in an emergency situation, please contact the UMass Police Department at 413-545-2121 .
What do Case Managers do?
Higher Education Case Managers serve their University and individual students by coordinating prevention, intervention, and support efforts across campus and community systems to assist at risk students and students facing crises, life traumas, and other barriers that impede success.
To that end, Higher Education Case Managers:
- Foster self-advocacy in students to manage their academic, personal, and fiscal responsibilities
- Work with students to develop action plans and resource connection
- Maintain contact and meet with students to address needs
- Collaborate with Families, University faculty and staff, and community partners to provide student support
- Advocate for students individually and systemically
- Evaluate threat and assess risk to self and/or the community
(HECMA, 2017)
Is Case Management Confidential?
Case Management is not therapy or counseling so the rules of confidentiality that might apply to medical or mental health treatment are not the same. With the exception of a crisis situation, the Case Manager shares information with campus colleagues about student behavior when there is a legitimate educational interest. It is important that students understand that the Student Life Team/Case Management Team are mandatory reporters. Therefore, if a student discusses a Title IX related matter, or other abuse, the issue will be reported accordingly.
If a student wishes to speak to a confidential resource, please see Campus Resources below to find out which campus resources are confidential. The confidential campus resources can work with the Case Management Team on a student’s behalf. If you would like for a confidential resource to connect with a case manager, please complete the appropriate release form.
Campus Resources
In addition to support from the Dean of Students Office, the following are other campus resources (both confidential and non-confidential) that are available to assist and support you:
Center for Counseling and Psychological Health (CCPH)
Middlesex House
Phone: 413-545-2337
Emergency on-call services, 24 hours a day, 7 days a week.
Center for Women and Community (CWC)
New Africa House
Phone: 413-545-0883
Ombuds Office
823 Campus Center
Phone: 413-545-0867
Student Legal Services Office (SLSO)
922 Campus Center
Phone: 413-545-1995
UMass Amherst Police Department(UMPD)
585 East Pleasant St.
Non-Emergency Number: 413-545-2121
In case of an emergency, dial 413-545-3111 or 911
Center for Multicultural Advancement and Student Success (CMASS)
Wilder Hall
Phone: 413-545-2517
Disability Services
161 Whitmore Admin Building
Phone: 413-545-0892
The Equal Opportunity and Access Office (EOA)
225 Bartlett Hall
Phone: 413-545-3464
Office of Global Affairs (OGA)
70 Butterfield Terrace
Phone: 413-545-2710
Off Campus Student Life
103 Bartlett Hall
Phone: 413-577-1005
Office of Equity and Inclusion
301 Whitmore Admin Building
Phone: 413-545-5703
Office of Religious and Spiritual Life
416 Student Union Building
Phone: 413-545-9642
Stonewall Center
Crampton Hall
Phone: 413-545-4824