Note: I understand that referrals from this form will be received during normal business hours and are not monitored after 5 PM, on weekends, or during official College holidays. If you feel there is an immediate risk of harm to self or others prior to submitting this form, please call 911.If you are in need of support for matters related to wellness or mental health, please access the BCOM Cares Team for further assistance. Disclaimer: Please see the College’s Grievance Policy. If you would like to file a complaint/grievance, please do so here: https://bcomnm.org/bcom_grievance_form/. Yes, I understand. NameYour Name:* First Last Your Position/Title: If you have chosen to remain anonymous, you do not need to provide your position/title if it is too specific.Your Email: Enter Email Confirm Email Need(s)Please check any need for advocacy, support, engagement, collaboration, or inquiry: Connect with a Diversity Advocacy Team member for guidance or just to talk. Guidance on strategies for engaging diverse communities Connect with a cultural resource, organization, or outlet Consult with the Diversity Advocacy Team on an interest to use tribal, cultural, or community names, symbols, or images for staff, faculty, and student sponsored activities Guidance on doing research with diverse cultures or communities Guidance on accessing clinical experiences in diverse communities Recommend an idea for programming, outreach, or collaboration Other, provide a detailed description below Please provide a detailed description for each selected need identified above.Please list any other College members/resources/departments or outside agencies that you have contacted about this need(s): CAPTCHA Δ