StudentHub

Welfare Check Request (via UQ Student Services)

Information provided will be reviewed by a Student Services staff member during business hours.

If you believe the student is in need of immediate assistance, or this is an emergency, please call UQ Security on (07) 3365 3333.

A note about confidentiality

Student Services adheres strictly to the Student Privacy policy at UQ when collecting, using and disclosing student information.

The information on this form is collected for the primary purpose of assessing and responding to the welfare check request.

For further information, please consult the UQ Privacy Management Policy at: http://ppl.app.uq.edu.au/content/1.60.02-privacy-management

Your contact details

Provide your details in the fields.

Name (required)

First Name

Last Name

Contact Details (required)

Phone

Mobile

Relationship to Student (required)Describe how you know the UQ student you are concerned about:

UQ Organisational Unit (if applicable)

UQ Position/Title (if applicable)

Student details

Provide the details of the UQ student you are concerned about.

Name (required)

First Name

Last Name

Student Number (if known)

Welfare concern

Why are you requesting a welfare check for this student? (required)Select ALL relevant reasons.

I am concerned for this student’s whereabouts

I am concerned for this student’s mental health or wellbeing

I am concerned for this student’s housing situation, or their risk of homelessness

I am concerned for this student’s medical or physical health

Other Reasons

Other Reasons (required)

Details

Who was the student’s last known contact? (required)

When was the last known contact with the student? (required)

How often do you usually have contact with the student? (required)

What attempts have been made to contact the student? (required)

Do you believe the student to be at immediate risk of self-harm or injury to anyone? (required)

Please provide any more information about your concern for the student's mental health or wellbeing. (required)

Is the student at immediate risk of homelessness? (required)

Is the student sleeping (overnight) on campus? (required)

Please describe the location the student is sleeping: (required)

Please provide any further relevant information about the student's housing situation. (required)

Please detail why you are concerned about the student's medical situation. (required)

Does the student have a known medical condition? (required)

Please provide us with information about the medical condition/s. (required)

Is there any more detail you would like to add about the student or your concern? (required)

Please 'Browse' to upload any files or documents you think will assist this welfare check:

Other people involved

If relevant to your concern, please provide the details of any other people involved.

Name

First Name

Last Name

Student Number (if known)

Contact Details

Relationship to Student