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Incident Reporting Form

The University of Central Missouri utilizes Maxient's Conduct Manager™ software to identify and manage concerns that impact on the Central community.

This form is intended to help any member of the community share a concern with the UCM administration.

If this is an urgent or life threatening situation, please call 911 or Public Safety at 660-543-4123.

A description of university student policies and expectations can be found in UCM's Guide to Good Decision-Making.

When you submit a concern, it will be routed to the appropriate office for review. Data collected from this reporting process is used in the development of the university's annual Security and Fire Safety Report

Please be aware that all UCM Employee's are required to report certain criminal acts including sexual assault, sexual misconduct, harassment or child abuse or neglect. Additionally, Campus Security Authorities are required to use the Mandatory Reporter Form to report crimes. It is located here: Mandatory Reporter Form

The University of Central Missouri believes that all students should have the opportunity to learn in an educational environment free from discrimination. Sexual harassment of students, including sexual violence and other forms of sexual misconduct, interferes with this right and will not be tolerated. Sex discrimination (including sexual harassment, sexual assault, and sexual violence) is prohibited at UCM. Federal Guidelines have been implemented here at UCM for responding to reports of sex discrimination. These reporting guidelines are in response to the Office of Civil Rights 2011 letter regarding Title IX, the federal law prohibiting sex discrimination in educational institutions. These procedures apply to all employees, students and third parties. Rape and all sexual violence are included as severe forms of sexual harassment under Title IX regulations. This means that all verbal or written reports of sexual assaults that occur on campus, at campus-related events, or that relate to discrimination, harassment, or retaliation alleged on campus, must be investigated by the university.

Here at Central, reports of sexual violence may be made at the Office of Public Safety, the Office of Student Experience and Engagement, University Housing and Human Resources. Public Safety will investigate all reports and make the appropriate contact with UCM staff. Students who do not want to make a report but would like assistance are encouraged to contact UCM's Counseling Center at 660-543-4060, the University Health Center at 660-543-4770, or the Title IX Coordinator (or designee) at 660-543-4114 for assistance in addressing sexual violence.

A detailed list of Title IX resources can be found here: Title IX Resources

Background Information

Your full name:

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You may write Anonymous

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

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Fields marked with a * are REQUIRED, all others are OPTIONAL.

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide. For non-students, please list an SSN or Drivers License number in the block labeled SID (Student ID #), if available.

Name or Organization

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.