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Bias Incident Report Form


IF YOU NEED TO REPORT AN EMERGENCY, DO NOT USE THIS FORM. INSTEAD CALL THE WAKE FOREST UNIVERSITY POLICE AT 336-758-5911 OR DIAL 911.



Those who have been the targets of, or who witness, a bias incident may use this online form to make the University aware of these incidents. Wake Forest University encourages all faculty, staff, students, and volunteers, acting in good faith, to report suspected or actual wrongful conduct. The University is committed to protecting individuals from interference with making a good faith report and from retaliation for having made a good faith report or for having refused to engage or participate in wrongful conduct. More information can be found here.

After you submit this report, it will be immediately dispatched to University Police for assessment of immediate damage and to ensure safety of individuals and property. This assessment may or may not involve immediate intervention by an officer. Additionally, the Bias Review Group will receive your report separately to independently determine what support mechanisms are available. The report may also be shared with other individuals at the University who have responsibility to address wrongful conduct as outlined in various University policies (e.g., sexual misconduct).

When reporting bias incidents through this form, please also note the following:

  • Your trust is important to us and we will take reasonable effort to respect and protect your privacy.
  • Anyone reporting an incident through this form should provide either a phone number or an e-mail address so that we may contact you if there is a need for clarification or if additional questions or concerns arise.
  • Students may also contact on-call campus medical and counseling professionals 24-hours a day by calling 336-758-5281 (Student Health) or 336-758-5273 (Counseling Center). These services are confidential.
  • Employees may contact the Employee Assistance Program for confidential services at 336-716-5493.
  • If you would like to remain anonymous and submit information you have regarding a suspicious person, any suspicious activity, or a crime that has occurred on or off campus, please use the University Police Silent Witness Form.
  • Any known or suspected violations of laws or of Wake Forest University policies or regulations may be reported to the Compliance Hotline.


If you have any questions about filing or completing a report, please contact the Bias Review Group at birt@wfu.edu

Background Information

Information provided in this section will help lend credence to the report, as well as provide the Bias Review Group with the ability to clarify aspects of the report with you. Again, your trust is important to us and we will take reasonable effort to respect and protect your privacy.

 
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Involved Parties

Involved party 1

Incident Details

Please list the individuals involved (including yourself, if appropriate or if you choose) and provide as much information as you can. Witnesses should also be identified here. This could include the individual's:

  • age
  • gender
  • height
  • weight
  • race
  • skin tone
  • hair color/texture
  • eye color
  • facial hair

Additionally, you should provide a description of their clothing, accessories, and any distinguishing features or characteristics. You should also identify any known affiliations (school they attend, organization they might belong to, etc.).

Finally, please identify the role for each individual/group listed:

  • witness
  • victim
  • alleged perpetrator
  • unknown
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Perceived basis of incident (check all that apply):
You must make at least one selection.

Supporting Documentation

Please attach any documents (e.g., photos, emails) that may help describe your concern here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission