Student Self-Referral to the ODUGlobal Student Advocacy and Care Team (ACT)

This form is for ODUGlobal Students to request assistance from the Advocacy and Care Team (ACT):

The Advocacy and Care Team helps ODUGlobal students facing challenges or barriers to their educational journey. We provide support, resources, and guidance to assist you with resolution.

Please complete the self-referral form below. If there is documentation or additional information that would assist us, please attach to this form or email directly to GlobalAdvocacy@odu.edu.

Name Name * First Last
Preferred Name

If you have a preferred name, please share with us (optional)
University Identification Number (UIN) *
Must be 8 digits. Currently Entered: 0 digits.
ODU Student Email *
How would you prefer to receive follow-up from our team? *

How would you prefer to receive follow-up from our team? Email Phone Virtual Meeting

Check all that apply.
Description of your concern(s) *

Describe the reason for this self-referral and any specific concerns.
Additional Comments

Optional: Provide any additional information that may be helpful for our team.
Documentation (optional, *no medical records)

Attach Files

Optional: Any support materials or documentation may be uploaded here or emailed directly to GlobalAdvocacy@odu.edu. Please do not include medical records.
Please check to confirm: *

Please check to confirm: I will monitor my ODU email for a message from GlobalAdvocacy@odu.edu and will respond promptly.

Please check this box to confirm that you will monitor your ODU email for a message from GlobalAdvocacy@odu.edu. Your reply will help us to assist you in a timely manner.