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UNO Care Team Form


If this is an emergency, call 911 or contact Public Safety at 402.554.2911 immediately. This form is intended to be used for reporting concerns about the health and safety of members of the UNO community. Please note, a specific incident is not required when using this form. General concerns may also be reported here.


For more detailed information on reporting and the UNO Care Team, visit the UNO Care Team website.

Reporter's Information

 
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Student, staff, faculty, other
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If your referral falls into two categories, please choose the option lowest on the list.
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Involved Individual(s) Information

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide.

Involved party 1

Detailed Summary

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I am concerned about the following behaviors (check all that apply):
You must make at least one selection.
Are you aware of any additional developments since the incident?(Required)
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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.

Submission