Incident Reporting Form

Assessment and Care Team (ACT)
Mission Statement
The Assessment and Care Team consists of a multi-disciplinary group of ACC employees including counselors, faculty, police, and student services staff. The ACT is committed to providing ACC staff, employees and students with supportive resources through a practical, collaborative, and thoughtful approach to the prevention, identifica­tion, assessment, intervention and holistic management of situations that may be disruptive in a student’s academic progress or to the well-being of campus employees. To educate and empower all members of the College com­munity, resources and procedures are available to prevent, deter, and respond to concerns. The ACT offers assistance to departments and individuals in determining indicators that may be of concern along with resources to support the learning environment.

Reporting Concerns To The ACT

ACT Report Form


Report all incidents and concerns that you have regarding an individual's behavior to the ACT, including as much detail as possible about the behavior/incident. Use your judgment as to what should be reported, erring on the side of over-reporting if in doubt.

Reporting an individual in crisis does not preclude taking additional action such as contacting the Director of Advising Services, Campus Police or the Vice President of Student Services, etc. This action should then be followed by completing the Assessment and Care Team (ACT) Form

In Cases Of Emergency
How You Can Help
ACT Report Form
Counseling Referral
Counseling and Wellness
Tips For Recognizing Distressed Students

Counseling Referrals vs. ACT Reporting - Which to Use?

When in doubt, report – ACT Report Form or call 281-756-3700.
Marked Changes in Academic Performance or Behavior

Excessive absences or tardiness
Repeated requests for special consideration,
especially when this represents a change verbally or in written assignments from previous functioning
Inability to concentrate
Significant decrease in academic performance
Unusual or changed pattern of behavior
Avoiding participation or sudden withdrawal from others
Dominating discussions
Excessively anxious when called upon
Disruptive, verbally aggressive or physically aggressive behavior
Exaggerated emotional responses
Easily agitated
References to Suicide, Homicide or Death

Talk of helplessness, hopelessness, or despair
References to suicidal thoughts and feelings,
verbally or in written assignments
Jokes publicly about killing him/herself
Suddenly withdrawing from organizations or clubs
Giving away possessions
Preoccupation with death
Preoccupation with violent acts
Homicidal threats
Unusual Behavior or Appearance

Marked change in mood, motor activity, speech
Hyperactivity or very rapid speech
Swollen, red eyes or bloodshot eyes
Slurred speech
Change in personal hygiene or dress
Appears sad or exhausted
Dramatic weight loss or gain
Sleeping in class
Strange or bizarre behavior indicating loss of contact with reality
Speech that is disjointed, tangential, fragmented or not based in reality