Complaint/Person of Concern Form

Reporter's Information

Enable additional features by logging in.

Your full name:

Your L Number:

Learn more

Your Lane student ID

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

This field is required.

Learn more

What kind of report is this?

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 yourself first and complete as many of the fields as possible. Next, add all other individuals involved by clicking "Add another person" and complete as many of the fields as you can provide. Please include L# if known.

Name of Individual or Organization

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Description and Narrative

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.

Email me a copy of this report

Complaint/Person of Concern Form

Reporter's Information

Involved Parties

Description and Narrative

Reasons for Report

Supporting Documentation

Submission