Incident Reporting Form

If you are in an emergency situation, contact the UC police immediately by dialing 911 on a campus phone. If you are using a cell phone, dial 911 and tell the dispatcher that you are on UC's campus to be connected with UCPD.

The University of Cincinnati values open expression and vigorous debate in the context of civility and mutual respect for diverse individuals and communities. We model an inclusive community by sharing our experiences, listening carefully to others, and debating ideas in civil, generous, and constructive ways. Bias incidents directly impact our ability to know, trust, support, and learn from one another.

The term bias incident refers to the use of language and/or actions that demonstrate bias (prejudice) against persons because of, but not necessarily limited to, their actual or perceived race, ethnicity, national origin, citizenship or immigration status, language, age, religion, religious practice, sex, disability (physical, psychological, and cognitive), gender, gender identity, gender expression, sexual orientation, parenting and/or pregnancy status, veteran status, or socioeconomic status. Not all incidents of bias violate the law or University of Cincinnati policy; however, such incidents do not align with our community values of mutual respect and inclusion.

Bias incidents include, but are not limited to, name-calling, stereotyping, belittling, or excluding others based on their identity. Some, but not all, bias incidents may rise to the level of discriminatory harassment, sexual misconduct, or other violations of policy or law.

Date of the incident*

Date

Time of the incident*

Hour Minutes

AM/PM Option

Where did this incident occur?

Specific location of incident*

Describe the incident. If you are making an anonymous report, please provide as many details as possible. Please summarize the facts in as much detail as possible: describe all comments, conduct, gestures, physical injuries, property damage, etc. Identify the person(s) involved in the incident by name, if known, or by physical appearance. List any possible witness(es) by name and contact information, if known.*

If you reported this incident to another university department, please include the date you reported it, who you reported it to (department and/or individual), and any response you received. If you did not report it to another department, leave blank.

Do you want to be contacted regarding this report?*

YesNo

If yes, please provide your contact information below.

Name

First NameLast Name

Phone Number

Please enter a valid phone number.

Email

example@example.com

Please verify that you are human*