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Student Rights & Responsibilities Incident Report Form


 

IF THERE IS IMMEDIATE RISK TO LIFE OR PROPERTY
Call 911 then 303-871-3000
(1-3000, if calling from a campus phone)

 

Student Rights & Responsibilities
Student Rights & Responsibilities addresses potential violations of the Honor Code and/or University policies by all University of Denver Students, including undergraduate and graduate students. The Student Rights & Responsibilities process is responsible for upholding the community values and promoting opportunities for holistic student living, learning, and growth. For more information please visit our website: Student Rights & Responsibilities | Student Affairs (du.edu). Please complete this form to report a potential violation of the Honor Code and/or University Policies.

COVID-19 Violations
To report a potential violation of University COVID-19 protocols, please use the COVID-19 Violations Report Form.

Academic Integrity incidents
To report a violation of the Academic Integrity Policy, please use the Academic Integrity Incident Report Form.

Disruption of the Learning Environment
To report a concern regarding conduct that is disruptive to the learning environment and if you would like to initiate the Policy on the Disruption of the Learning Environment, please complete a Disruption of the Learning Environment Report Form.

Student Outreach & Support Referral
If you have a concern about a student, but do not believe it rises to the level of a policy violation, you can submit a SOS Referral Form. This form can be used for reporting student behavior related to academic, social, and personal issues.

Office of Equal Opportunity and Title IX Reports
If you have a concern regarding a bias, harassment, discrimination or Gender-based Violence, or Title IX incident, you may report via Bias Incident. This form can be used for reporting incidents involving both students and non-students.

Please complete the following Incident Report to the best of your ability. Thank you!

Your Information

 
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(Academic Misconduct cases use another form - see notes above.)
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Involved Individuals

Please list the individuals involved, including as many of the listed fields as you can provide.

Please list all involved individuals in the incident description, which is the next entry on this form.

If you are responding as an employee, do not list yourself or any other person responding in their employment role (examples: Resident Assistants, Campus Safety Officers, Administrator on Call).

Involved party 1

Incident Information

Please provide a detailed description of the incident/concern using specific, concise, and objective language

*NOTE: Your Incident Description may be sent to the student as is.

Incident Report Writing Tips:

  • Complete the report thoroughly and accurately, including all pertinent information about the incident and persons involved (time, place, date, names, and addresses). The report should answer who, what, when, where, and how (e.g., how many beers, what kind, who is holding them, where the alcohol is in relation to the people, etc.)
  • To avoid confusion about which individual you are referring to, use third person and identify individuals with their last name and title, when appropriate (e.g., Resident Johnson, RA Stevens).
  • Be concise and to the point, while still being thorough and complete.
  • Do not write from your emotion - leave editorial out. Use objective instead of subjective language.
  • Do not speculate - you are reporting facts, not possible assumptions.
  • Complete the report immediately after the incident - details fade fast.
  • Make sure to proof read the text of your Incident Report before submitting.
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Were any of the following involved in the Incident (Check all that apply)?(Required)
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Did you refer any individual to any of the following offices (Check all that apply)?(Required)
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Supporting Documentation

Please attach any relevant documents, emails, photos, etc. For Photos, please submit in .jpg, .jpeg, or .png format or as a PDF. DO NOT attach in .heic format. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission