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Student Concern Form

OVU Student Life
1 Campus View Drive, Vienna, WV 26105-8000
304.865.6084 | www.ovu.edu/studentlife

Please use this form to convey any academic or non-academic concerns about a student.
Required fields are in pink.

Date of Submission:

Student Information

Student Name: Student email (optional):
Concerns (please check all that apply). This student:

Academic concerns:

is performing poorly on quizzes/exams.
is not attending class regularly.
is routinely late for class and/or routinely leaves class early.
is disruptive or rude in class.
appears not to be engaged in class.
neglects to finish and/or turn in assigned work.
is routinely not prepared for class.
requires study skills assistance.
is having difficulty with career decisions.
is not utilizing the tutoring center.
is negatively affected by students around him/her.
Other; please explain:

non-Academic concerns:

has a housing/roommate concern.
is not adapting socially.
could benefit from substance use/abuse education and/or counseling.
could benefit from sexual counseling.
is allowing extra-curricular activity to interfere with academic progress.
cannot find extra-curricular activities that meet his/her interests.
Personal problems (family members, home, etc.) appear to be interfering with social and academic development.
Relationship issues (boyfriend, girlfriend) appear to be interfering with social and academic development.
Student has expressed extreme concern with financial issues.
Other; please explain:

Faculty/Staff Information

Name:
Email: Phone:
Relation to Student (choose one): Course (if applicable):

Sport/Activity:

Ph: (304) 865-6085 email: noelle.hunter@ovu.edu

http://forms.ovu.edu/studentconcern.shtml

Last updated on February 13, 2019
Page maintained by Bruce Terry,