Luther Seminary Incident Report Form


************ALWAYS CALL 911 FIRST IF YOU FEEL YOU ARE IN DANGER************



***You do not need to fill out this form to report an incident.  You may make an incident report in person, via phone call, email, text, or any other way you feel most comfortable/safe.***

You may submit this report anonymously if you so choose.  This form is NOT collecting your email or other data unless you self-identify.

Online incident reports will first be sent to the Title IX Coordinator to determine if Title IX violations have occurred.  If not required to be adjudicated through the Title IX process, the Title IX coordinator will discuss with and pass along the case to the appropriate party/parties.

Please fill out as much information as you feel comfortable sharing.

While the incident you are reporting may fit more than one category, please choose the category that is the core of the issue you are reporting, so as to help your report reach the most appropriate responder.

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Enter your name (if you choose to identify yourself.)
If you have provided your name, please indicate the best method(s) to contact you (email, phone, etc.)
Are you a student, staff, faculty, or "other"? *
What kind of incident are you reporting? *
Date of Incident? *
MM
/
DD
/
YYYY
Time of Incident? *
Time
:
Location of Incident? *
Person(s) involved? *
Were the person(s) involved: 
(Select all that apply)
 *
Required
Please describe the incident: *
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