Campus Incident/Complaint Reporting Form

This form is for use by any member of the campus community (students, employees, and guests) to submit an initial report of a campus incident or complaint. Once submitted, the report will be reviewed by the Director of Student Support Services for follow‐up regarding next steps, including the possible involvement of additional members of the administration. Every effort will be made to keep your personal information confidential, to the extent possible depending on the specific incident, complaint or situation. If you choose to submit this report anonymously, please be aware that it may limit the ability for thorough follow‐up. Once complete, please submit form to the Reception Desk in Founders Hall.
Type of Complaint (check all that apply):



Now(UTC - 08:00)
If you checked any boxes other than Title IX, have you attempted to resolve the issue with the other party?:
In the case of Academic or Behavioral/Personal Conflicts, you must first try to address the issue directly with the individual in question (this may include utilizing a mediator at your discretion). *Sexual misconduct incidents are NOT expected to be addressed directly. In those cases, please submit a complaint form as soon as you are able, in order to have the issue addressed formally.
Please provide as much detail as possible, including date, times, location, names of involved individuals, etc. If needed, attach any relevant supporting documentation and/or use additional space beyond what is provided below.
You may submit this form anonymously; however, if you wish to be contacted for follow-up and/or support, please provide your contact information below.
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