Hazing Incident Reporting Form

Background Information

Though not required, we ask that you please provide your name and contact information. Your identity will be held in confidence. It will not be disclosed to the individuals or organization in question. Please report the acts of hazing even if you choose to omit your name and contact information. If you believe a student is in immediate danger, please contact the University of Central Oklahoma Police Department at (405) 974-2345. Thank you.

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Name or Organization

Select Gender

Select Role

Student ID Number (Do not include asterisk)

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Please note that if you do not know or choose not to provide the name of the organization that you are reporting, the University may be limited in its ability to address the allegations.

If you feel that any person is in immediate danger - immediately, call UCO Police at 405-974-2345 or call 9-1-1.

What is the name of the organization that you are reporting? This field is required.

Please provide a detailed description of the incident/concern using specific concise, objective language.(Required) This field is required.

How did you become aware of the act(s) and/or event(s)?(Required) This field is required.

Are there other individuals who could corroborate the information that you are providing? If so, please provide their names and contact information, if available.(Required) 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.

Background Information

Involved Parties

Questions

Supporting Documentation

Submission