USC Trojans Care 4 Trojans (TC4T) Form

This form is not to be used to report an emergency.

If you find yourself in need of immediate attention due to an emergency or crisis situation in which your safety is at risk, please contact the Department of Public Safety at 213-740-4321. In the event you are experiencing difficulty with your emotional or mental well-being, please contact Counseling & Mental Health at 213-740-9355. Both DPS and CMH are available 24/7.

Each TC4T submission will be reviewed and responded to by a staff member from Campus Support & Intervention. For more information, contact Campus Support & Intervention at uscsupport@usc.edu.

While you may not always be aware of the follow-up done in response to your report, please know that a professional staff member will be reaching out to the person of concern. We appreciate you entrusting us with your concern and we will make every effort to connect with them to provide support. If you have further questions about how the TC4T program works or you would like support for yourself, please contact us at 213-740-0411 or uscsupport@usc.edu.

I understand that the form I am submitting is not for an emergency.

I am concerned about

Details of Individual I am Concerned About

First Name

Last Name

Phone

Does the individual you are concerned about reside in USC-Housing?

YesNo

Address

If a student, please provide an address for non-USC Housing.

Street

City

State

ZIP Code

Student Organization(s)/Affiliations

If a student, please list any student organizations or campus involvement for this individual (we may use this information to help us reach out to the individual)

Faculty/Staff Department

How long have you been aware of this concern?

TC4T DESCRIPTION

Please describe, in detail, the nature of concern; what you and/or others have witnessed; how you first learned of this concern; location; and any other pertinent information.

Example: For about two weeks now, I have noticed that a classmate of mine has not been attending our morning writing class. Her name is Tammy Trojan and she lives on the same floor as me in Parkside Arts & Humanities. I haven’t even seen her on our floor. I asked other people on our floor and they haven’t seen her either. Her roommate said that Tammy is hardly ever in the suite because she is always hanging out with some friends that live off campus. I heard from some other people on the floor that she has been out drinking every night with these new friends. Every time I stop by her room, she is never there. I am worried about her. Thank you for your help.

Example: My colleague Tommy has not been himself the past few weeks. Though I do not know the details I know he is going through some issues at home. Whatever it is he it is affecting his ability to pay attention and meet deadlines. I am concerned that our supervisor has noticed and it will negatively impact his work. I want to help him but am not sure how.

Example: I love my science professor – Prof. Trojan is always upbeat and engaging. The past few months she has seemed down and has at times forgotten where she was in her course presentation. This is not like her and I am worried. She is really awesome and I want to make sure she is okay.

Reporter Information

If you are a faculty or staff member concerned about a student, we ask that you consider providing your contact information (below) for follow-up questions and to work with other professionals in responding to the situation. However, requests from reporters who wish to remain anonymous will be honored.

Your First Name

Your Last Name

Your Phone

Your Email

Relationship to Individual Student

Relationship to Individual Employee

Have you addressed your concern with this individual?

YesNo

Please describe how you addressed your concern and any response.

Contact Information