Incident Reporting Form
This is not an immediate response line. In the case of emergency, please call 911.
1. How would you describe this incident?
Check all that apply
I have reason to believe a crime has been committed
I have reason to believe a crime is being planned
I have reason to believe an unsafe condition exists
I have reason to believe there has been or will be a violation of some other GROOVE U policy
I wish to file a formal grievance against another student(s), a faulty member(s), or a member(s) of administration
Something else not described above that I would like addressed
2. Please describe the incident in detail
3. Where did/where will this incident take place
4. Approximately what date did/what date will this incident take place?
5.Approximately what time did/what time will this incident take place?
Information will be kept confidential and only used for investigative purposes.
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