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Bias Incident Reporting Form


This reporting form is NOT intended for emergency response. If you need to report an EMERGENCY or incident that poses an imminent risk of harm, please call University Police at 262-472-4660 or dial 911

What is a bias incident?

A bias incident is any action or attitude that interferes with impartial judgement that is motivated (or appears to be motivated by, in whole or in part) by an individual's actual or perceived race/ethnicity, religion, national origin/immigration/citizenship status, sex, sexual orientation, gender identity or expression, economic status, language, age, size, pregnancy or family/marital status, disability, veteran or military status, or any other identity status protected by University Policy

What is the purpose of this form?

The purpose of this reporting form is to collect and share information related to potential bias incidents that occur on and/or off-campus to UWW students or employees in order to offer support to impacted parties, as well as provide general education to build a better inclusive community.

The identity of the reporter and/or person(s) impacted will be kept confidential to the extent possible under applicable state and federal law. Submitting this form may or may not result in Bias Support and Education Team or university action depending on the type of incident.

Who should complete this form?

Anyone who has experienced, witnessed, or learned of a potential bias incident should complete this form. You may fill out as much or as little information as you choose. The ability of the University to respond may be limited if key information is not provided and we are unable to learn more from the reporter. Please include your name if you wish to be contacted.

What happens after I submit this report?

Every effort will be made to evaluate your report promptly. The timing and manner in which in which the incident will be addressed will vary depending on the information provided.

 

Background Information

 
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student, faculty, staff, community member, etc
Email address must be of a valid format.
This field is required.
This field is required.

Involved Parties (if known)

Include names of any known target(s), responsible parties, and any witnesses. This information is optional.

Involved party 1

Questions

This field is required.
Was this incident reported to any other campus agency or department? If yes, please indicate where in the Incident Description section above.(Required)
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This field is required.
This hate/bias incident targets:(Required)
You must make at least one selection.
This field is required.
This field is required.
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Type of Incident:(Required)
You must make at least one selection.
This field is required.
Would you like someone to contact you in regard to this report? (Please note we may attempt to contact you regarding this incident to gather more information.)(Required)
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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.

Submission