JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CitrusTV Incident Form
If you have felt or seen something on or at CitrusTV which makes you, or anyone uncomfortable, unsafe, or unwelcome, please report it here. Please include as much information as possible so the we can look into the matter and determine a solution.
If you are looking to submit a suggestion on how an Executive Staff member can improve at their job, on coverage/reporting specifically, or have an overall suggestion for the station to improve, go to CitrusTV.com/feedback. This form is linked to the CitrusTV General Manager's account and is shared with only the Associate General Manager.
For Bias related concerns, please complete this form:
Bias Incident Report
For Hazing related concerns, please complete this form:
Hazing Report
For Sexual Harassment/Title IX-related concerns, please complete this form:
Title IX - Sexual/Relationship Violence and/or Stalking Report
If this is an emergency, please contact the Department of Public Safety at: 315.443.2224, 711 (from any campus phone), #78 (from most wireless carriers). You may also call 911.
Sign in to Google
to save your progress.
Learn more
Full Name (optional)
Your answer
What is the nature of this report? (If other, please specify)
Someone made me feel offended and/or uncomfortable
Something said or shown in CitrusTV programming offended me or another party
Other:
Clear selection
Please describe the incident in as much detail as possible
Your answer
On which show did this problem occur? (If applicable)
Your answer
Where did this problem occur?
Your answer
When did this happen?
Your answer
Would you like to discuss this incident in person?
Yes
No
Other:
Clear selection
Do you have a preference on who meets with you to discuss this issue?
General Manager
Associate General Manager
Both
Other:
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of CitrusTV.
Report Abuse
Forms
