Report a Bias Motivated Incident!

REPORT A BIAS
MOTIVATED INCIDENT!

This page is designed to offer individuals who have experienced any form of discrimination or problems related to biased attitudes or action against one's identity a means of reporting such incidents. 

IF THIS IS A MEDICAL OR POLICE-RELATED EMERGENCY,

PLEASE CALL 911

While information concerning the event is required, identifying information is completely optional.  Also, keep in mind that the more information you give allows us to better assist you.  And as always, please remember that all information given is confidential.

How May We Contact You? (OPTIONAL)
This section is optional.
This section is optional.
( )
-
This section is optional.
Information About the Incident (required information noted with asterisk)
If you were one of multiple people affected, please choose "Me" and note this in the event description below.
Please describe the location and date/time of the incident to the best of your ability.
Please describe the incident in as much detail as possible. This will allow us to form a better response to the situation.
If the perpetrator is not known, please indicate this here with "Perpetrator unknown."


Please remember that if you do not check the second box, you will NOT be contacted by the university, and all information will remain with the university for reporting purposes.

Additional information optional – If you are the survivor of the incident, please complete the information below. If you are an observer or the incident was reported to you, fill out as much information as you know about the survivor.









Need assistance with this form?