We realize that some issues are not isolated incidents and are ongoing. If this is an isolated incident, indicate the specific date. If this is an ongoing issue, to the best of your ability indicate the approximate date that the issue emerged.
Please describe as specifically as possible, to the best of your recollection, your involvement in, or observation of the incident. Include any information you believe may be relevant to this inquiry. Be aware that if the incident references alleged violations of the Code of Student Conduct and/or Residential Life Community Standards, your statement may be introduced during student conduct proceedings.
Please indicate all individuals involved in this incident as well as others that could provide information related to the actions and or events being reported. Provide as much information about the individual(s) as possible, including their last name, first name, phone number, and address. If the individual is not a student, indicate their relationship to the campus if known. If you do not know the names of certain individuals involved, provide as much identifying information about them as possible.
Based on the details you included above, please describe your most immediate needs or concerns regarding this issue. Please list any next steps, outreach, or remediation that you would like to see, as specifically as you can.
If you have discussed or sought assistance regarding this incident with staff from an on-campus office(s), please indicate which campus offices.