Campus Safety and Security Incident Report

Tell Us About You

If you wish to make an anonymous report of concerning or worrisome behavior, a case manager will evaluate the report and determine what follow up (if any) is necessary to address the concerns. Please consider providing your name and contact information to allow us to call or email if we have additional questions regarding your report.

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Your name:

Your position/title or ID#:

Your phone number:

Your email address:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please list the individuals involved in this incident and provide as much detailed information about the individuals as possible.

Name

Person's Role

BYUH ID Number

Phone number

Email address

Hale/Address

Reason(s) for Report

Please indicate the nature of this incident report.(Required)

Harassment

Disorderly Conduct

Theft

Vandalism

Danger

Other

You must make at least one selection.

Please indicate the relevant information that pertains to this report: Describe the behavior/activity. Description of the property taken and estimated value. If a vehicle was used by subject, please provide description (year, make, model, color(s), license). If know, please describe the clothing worn, gender, race, height, weight, hair, eyes, etc. of the subject involved.(Required) This field is required.

Supporting Documentation

SUPPORTING DOCS SECTION TEXT 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Tell Us About You

Involved Parties

Reason(s) for Report

Supporting Documentation

Submission