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Rocket Care Report

If you feel the threat/behavior is imminent, or an act of violence or a suicide attempt has occurred, please contact The University of Toledo Police Department at 9-1-1.

The Rocket Care Report is used to connect UToledo students with assistance to ensure their well-being, and a safe learning environment. Rocket Care Reports can be submitted by any UToledo Community Member (faculty, staff, or student), or a parent/family member.

Once the form is submitted, a team member from the Center for Advocacy and Student Experience (CASE) will follow-up with the student of concern and the involved parties.

If you have questions, please feel free to contact the office via telephone at (419) 530-4357 or email at case@utoledo.edu. Please note, this report may be shared with the Student of Concern or other University Staff.

Thank you for doing your part to promote health and safety here at The University of Toledo.

Reporter Information

Please provide the following information.

Your First and Last Name:

Your Position/Title:

Your Phone Number:

Your E-Mail Address:

Email address must be of a valid format.

Incident Date(Required):

This field is required.

Incident Time:

Incident Location(Required):

This field is required.

Specific Location:

Involved Persons

Please complete as much information as known to the reporter.

Name or Organization

Select Gender

Role

Rocket Number

Phone Number

Email Address

Narrative Information and Questions

Supporting Documentation

E-mails, Photos, Videos, and Other Supporting Documentation May Be Attached. Maximum of 12 Megabytes Per File. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Reporter Information

Involved Persons

Narrative Information and Questions

Supporting Documentation

Submission