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Concern and Support Form

Do not use this site to report events, presenting an immediate threat to safety or security. If this is an emergency, please contact police at 911.

This reporting form and information is private, but not confidential and does not route directly to confidential student services.

For assistance in navigating Incident Type below, please refer to the list below:

Behavioral/Student Conduct:

Potentially concerning behavior of students or non-students on campus. It also includes reports of Academic Dishonesty, potential violations of the Student Conduct Code (on or off campus) or other potential university policy violations. All policies and expectations can be found online at Policies: Blugold Student Conduct Code | UW-Eau Claire (uwec.edu)

Inclusivity or Bias Related Concerns:

Receive support or report behavior, conduct, speech, images, or expression that discriminates, stereotypes, excludes, harasses, or harms anyone based upon their actual or perceived identity such as race, color, ethnicity, national origin, sex, gender identity or expression, sexual orientation, disability, age, or religion.

Campus Housing Incident:

Potential concerns or behaviors that take place in our campus housing facilities (Residence Halls or On Campus Apartments). This includes community concerns, roommate issues and potential violations of the Residence Hall/Apartment Policies and Expectations or the Student Conduct Code. All policies and expectations can be found online at Judicial Board | UW-Eau Claire (uwec.edu)

Case Management/Student of Concern:

Requests for assistance or support with mental health, physical/medical concerns, basic needs, family problems, grief/loss, general distress, navigation of systems/processes for access to resources, etc. that do not rise to the level of an immediate emergency (911) call.

Concerns about Faculty/Staff:

Any concerns regarding CWU employees (student staff, professional staff, faculty, etc.) including but not limited to potential violations of employee policies or expectations.

Sexual Misconduct – Title IX

Any potential Sexual Misconduct incident involving a member of the campus community, including but not limited to sexual harassment, sexual intimidation, sexual violence, intimate partner, or domestic violence, and/or stalking. May include referrals and support, as well as formal investigation.

Background Information

Your full name (optional):

Your position/title (optional):

Your phone number (optional):

Your email address (optional):

Email address must be of a valid format.

Report Type(Required):

This field is required.

Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Specific location:

Involved Parties

Please include names of alleged, witnesses, targets and anyone else who may be involved in the concern you are reporting.

Name or Organization

Select Role

ID Number (optional)

Phone number (optional)

Email address (optional)

Questions

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.

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