UMCARES & Maxient Incident Reporting

Reporting Party Information

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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.

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Please call UM police (205-665-6500) or 911 if threat is active or imminent

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

Involved Parties

Please enter as many detail regarding the involved parties as possible. It is not necessary to fill every blank but we do need to be able to identify the involved parties. RAs, Emergency Duty staff, and some administrators are authorized users and may look-up student information. For this feature to work, you will need to have entered your login information in the Background section. If you are on the list of authorized Maxient employees, binoculars appear next to "Name of Involved..."

Name of Involved party, not a number

Gender

Role

ID Number (with M in front)

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Required field. Please provide as much detail as possible in regards to the needs or behavior(s) that prompted your concern. Details regarding threats of harm to self or others, dates and times, or changes in behavior are helpful. Reports are reviewed by members of the appropriate behavioral/threat assessment team. Call 911 in cases of immediate threat or emergency.(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.

Reporting Party Information

Involved Parties

Supporting Documentation

Submission