UTSC Academic Alert Referral Form | Academic Advising & Career Centre

The purpose of the University of Toronto Scarborough (UTSC) Academic Alert Referral Form is to provide faculty, instructors, TAs and lab coordinators with assistance for supporting current students who may be experiencing concerning academic difficulty. With the range of class sizes on campus, it may be challenging to identify the extent of difficulty a student is experiencing until later in the course; nevertheless, connecting students with campus supports at any point will help improve their chances of being successful.

Please use the form below to fill out as much information as possible and then click on ‘Submit’. Once this confidential form has been submitted, you will be contacted by a representative from the Academic Advising & Career Centre (AA&CC), within 1-2 business days to discuss next steps.

Please do not use this form for:

-A student in crisis (i.e. severe distress). To support a student in crisis during hours of operation, please call the Health & Wellness Centre (SL270) at 416.287.7065. For after hours support, please call UTSC’s Community Police (SW304) at 416.287.7333. For other emergency resources in the community please visit: utsc.utoronto.ca/wellness/emergency.html.

-A student who has disclosed a disability and/or has disclosed they are registered with AccessAbility Services. Please call AccessAbility Services at: 416.287.7560.

If you have any questions about this form, please email the Academic Advising & Career Centre (AA&CC) at: academicalert@utsc.utoronto.ca

Student Name

Student Number

UTORid (if known)

Faculty, Instructor, TA or Lab Coordinator's Name (First and Last Name)

Faculty, Instructor, TA or Lab Coordinator's Email Address

Academic Department

Please select all of the issues or behaviours that you are concerned with:

Missed or failed more than one assignment and/or exam

Attendance concerns

Change in demeanor (e.g. seems anxious, withdrawn, tearful, angry, frustrated)

Difficulty synthesizing, comprehending and/or coherently articulating

Other

As the Faculty, Instructor, TA or Lab Coordinator

I have discussed this issue(s) with the student

I have not discussed this issue(s) with the student

Purpose of this form

I understand that this form is not intended to report a student in crisis and that submissions are checked during the AA&CC’s regular hours of operation. The AA&CC will aim to respond within 1-2 business days, but there may be delays during peak academic periods. To support a student in crisis during regular hours of operation, please call the Health and Wellness Centre (SL270) at 416.287.7065. For after hours support, please call UTSC Community Police (SW304) at 416.287.7333. For other emergency resources within the community, please visit: utsc.utoronto.ca/wellness/emergency.html.