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Behavioral Intervention Team (BIT) Concern Form

INSTRUCTIONS: Fill out *ALL* of the following information:
First Name:    
Last Name:    
Phone Number:    
Email Address:    
I am a(n): 
Department: 
(if employee):  
 
I am requesting that the BIT Team follow up with:
First Name:    
Last Name:    
Is a(n): 
Student ID#:
(if available):  
Phone Number:
(if known):  
Email Address:
(if known):  
Select all that apply:







Please Explain:  







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Effective Dec. 3, 2018, Lanier Technical College's address will be: 2535 Lanier Tech Drive, Gainesville, GA 30507
Phone: 770-533-7000 | Fax: 770-531-6328
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