NEST Referral Form Fall 2025

Dear Colleague,

Thank you for your concern & taking your valuable time to refer a student to our enhanced academic services @ NEST.

If you have multiple students to refer or would rather that we schedule a phone or Zoom call, please reach out to us @

son-nestteam@listserv.cc.emory.edu

Thank you for your time,

NEST Team (Lori & LaDonia)

Student name (Last, First)

Student Email

Concerns for the student

Academic

Welfare & Wellbeing

Course average

<70% Prelicensure

>70% Prelicensure

<83% Postlicensure

Date Referred

mm/dd/yyyy

Referral Source

Your name

Anything you want us to be aware of?

Please let us know any history, extenuating circumstances, or other non-academic help the student may need.

This form is confidential & can only be accessed by the NEST team, FERPA COMPLIANT

Suggested Support Plan

Let us know your recommendation for supporting this student.

-Student needs 1:1 tutoring

-Student needs assistance with time management.

-Name of a student you recommend for peer tutoring

**This is not a guarantee the student will be offered this support, we want your expert opinion to assist us.**

Send me a copy of my responses