Reporting Form for Hazing

REPORTING PERSON CONTACT INFORMATION
PLEASE READ - IMPORTANT INFORMATION
You are not required to submit any personal information. Your report will result in an investigation regardless of whether or not you choose to submit your name and contact information. Should you choose to submit your name and contact information, you may be contacted by Student Development for a confidential interview so that the department may gather additional information from you regarding your incident report.
Name of person filing report (optional):   
Phone number of person filing report (optional):   
Email address of person filing report (optional):   
Reported by:    A directly involved party    A third party
If reported by a third party, the third party's relationship to the directly involved party/group(s) or organization(s):
Would you like your identity to remain confidential to the parties involved?
If you select yes, your identity will remain confidential from people involved
in the case; however, you will be contacted confidentially by an investigator. Yes    No

INCIDENT INFORMATION

To the best of your knowledge:
*What organization(s) or group(s) was/were involved in the incident?
*If actual name is unknown, what types of organization(s) or group(s) was/were involved in the incident?
Location of incident (building name, street address, office number, whatever details are known):
Time of incident:      
What was the nature of the incident? Please check all that apply.
Physical    Emotional    Psychological    Other:
Was alcohol involved in the hazing incident?    Yes    No
Did any injuries result from the hazing incident?    Yes    No
What occurred? (Please provide specific, detailed information.):

(5000 characters maximum length)
Who were the individuals involved?

(500 characters maximum length)
What led up to the incident? (Please provide specific, detailed information.):

(5000 characters maximum length)

Please retain any supporting documentation - text messages, photos, videos, social media posts - that would be useful in the investigation.

WARNING: False reports impede the ability of Student Development to meaningfully conduct investigations of legitimate hazing incidents. Knowingly submitting a false report of hazing may result in disciplinary sanctions.