Report an Incident (Public)

Hello, please share some information about yourself.

We will do our best to protect your privacy, but we do need your partnership in order to address your concern as we may need to contact you for follow-up.

Your full name:

Your relationship to CUA:

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student, faculty, Brookland neighbor, etc.

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

What student(s) are you concerned about?

In order to address your concerns, we need to know what student to contact. If you have only a partial name or just a description, that is a great start. (Examples: James Earl Jones; or 6'2" bearded blonde introduced himself as John)

Name or Description (including how you know the student)

Select Gender

Student ID Number (if known)

Phone number (if known)

What is the nature of your concern?

Please provide as complete a description of this concern as possible.(Required) This field is required.

If there are others we should be talking to, please share their names and contact information below. This field is required.

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.

Hello, please share some information about yourself.

What student(s) are you concerned about?

What is the nature of your concern?

Supporting Documentation

Submission