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Student Conduct/Concerning Behavior Reporting Form


If this is an emergency, please call 9-1-1.

The Student Development Department at Indian Hills Community College is charged with upholding the Student Code of Conduct, which identifies behavioral expectations for all students on- and off-campus. If you have knowledge of an Indian Hills Community College student potentially violating the Student Code of Conduct, you are encouraged to notify our office of the incident. 

Please use this form to report any behaviors of concern involving Indian Hills Community College students, whether these behaviors occur inside or outside of the classroom setting. Reportable behaviors may include Student Code of Conduct violations, a student who you feel may be struggling physically or psychologically, or any other behaviors of concern that you would like to see addressed or would like to discuss. When completing this form, please include your name, title, and contact information. Incident reports submitted anonymously may limit our effectiveness in dealing with concerning behavior.

If you have any questions regarding filing an incident report, please contact the Student Development Department at 641-683-5155.


Click here for the Student Academic Integrity Form.

Click here for the General Complaint Form.

Click here for the Title IX/Sexual and Gender-based Misconduct Form.

Click here for the Grievance Procedure for Discrimination Form

Non-Discrimination Policy: It is the policy of Indian Hills Community College not to discriminate on the basis of race, creed, color, sexual orientation, gender identity, national origin, sex, disability, religion, age, political party affiliation, or actual or potential parental, family or marital status in its programs, activities, or employment practices as required by the Iowa Code sections 216.9 and 256.10(2), Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C. § 2000d and 2000e), the Equal Pay Act of 1973 (29 U.S.C. § 206, et seq.), Title IX (Educational Amendments, 20 U.S.C.§§ 1681 – 1688), Section 504 (Rehabilitation Act of 1973, 29 U.S.C. § 794), and the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.).

 

If you have questions or complaints related to compliance with this policy, please contact Associate Dean, Student Development, 525 Grandview Ave, Ottumwa, IA 52501, (641) 683-5155, equity@indianhills.edu (students, faculty and staff); Executive Dean, Centerville Campus and Learning Services, 683-5174, learningservicesequity@indianhills.edu (students with disabilities); Director of the Office for Civil Rights U.S. Department of Education, John C. Kluczynski Federal Building, 230 S. Dearborn Street, 37th Floor, Chicago, IL 60604-7204, phone number (312) 730-1560, fax (312) 730- 1576, ocr.chicago@ed.gov

 

Your Information

 
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Involved Parties

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Description and Narrative

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BEHAVIORAL CONCERN
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CONDUCT ISSUE
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INFORMATIONAL
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Was law enforcement involved with the incident?
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If law enforcement was involved, please select the agency that responded? (Check all that apply)
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Was anyone arrested by law enforcement?
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Did anyone sustain an injury or experience a medical condition during the incident?
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Did emergency medical personnel respond?
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Was anyone transported to a hospital?
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Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
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