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Your name (e.g., Dr. Brutus Buckeye)
Please include your honorific as well as your first and last names. This is how you will be referenced in the email to your student.
Your OSU email address (e.g., buckeye.123@osu.edu)
Your relationship to the student
Academic Advisor
Professor/Instructor
Staff
Other
Your OSU department/unit
Student's first name
Student's last name
Student's OSU email (e.g., buckeye.123@osu.edu)
Please select ALL of the areas that might be of concern for this student. (This information will be shared with the student you are referring, as we will provide targeted support in these areas.)
Study skills / Making a study plan (Office of Student Retention Support)
Test-taking / Test anxiety (Office of Student Retention Support)
Time management / Reducing Procrastination (Office of Student Retention Support)
Increasing or maintaining motivation (Office of Student Retention Support)
Note-taking skills (Office of Student Retention Support)
Focus/concentration (Office of Student Retention Support)
Keeping up with coursework (Office of Student Retention Support)
Stress management (Office of Student Retention Support)
May benefit from tutoring (Learning Center Support). Please indicate subject
Other
*If known* Select student's major
Biology
Business
Education
English
Engineering Technology
History
Psychology
Social Work
Theater
Zoology
Other
Other comments?
If you feel that more specific information would help us provide better support, please explain here. However, please maintain the student's confidentiality and privacy and do NOT share specific details (e.g., grades, life situations, disabilities, etc.).