Incident/Informational Report

Background Information

The following information should be completed by the individual(s) submitting the incident report.

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Person(s) submitting report:

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This should be the name(s) of the persons submitting this incident report.

Your position/role:

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(ex. Student, Resident Assistant, Community Director, Faculty, Staff, Community Member)

Your phone number:

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Please list a preferred contact number, should we need to follow up.

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

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When did this incident occur?(Required):

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Time of incident:

Location of Incident(Required):

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Specific Location:

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(ex. Building & Room Number

Involved Parties

Please identity all individuals involved in this incident and their roles.

Name or Organization

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University ID Number

Phone number

Email address

Hall/Address

Incident Information

Please indicate if the following were involved in this incident (select all that may apply):

Substance Presence/Use (Alcohol or other drugs) Weapons Physical Violence Bias Damage/destruction

You must make at least one selection.

Please indicate if any of the following services were called or on the scene:

9-1-1 Campus Safety and Police Town of Elon Police Elon Fire Department

You must make at least one selection.

Please provide a detailed description of the incident/concern using specific concise, objective language. Please provide as much detail as possible in describing the behaviors and activities that occurred. The use of direct quotes, including profanity or abusive language, is encouraged. Note: Please avoid using pronouns when multiple individuals are involved, to help with clarity.(Required) This field is required.

Supporting Documentation

Please upload any supporting documentation that may provide additional context to the incident report (pictures, text messages, emails, etc.). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Background Information

Involved Parties

Incident Information

Supporting Documentation

Submission