Report a Student Organization Incident

This form will allow you to confidentially submit a report regarding incidents involving a student organization at The University of Texas at Austin including risky behavior, dangerous activities, activities involving physical or emotional injury, and/or hazing.

A submitted report may result in an investigation by the Office of the Dean of Students into the alleged incident. Every attempt will be made to keep all information submitted in this form confidential.

Please note that false reports impede the ability of the Office of the Dean of Students to meaningfully conduct investigations of legitimate incidents. Knowingly submitting a false report or misuse of this University form will result in disciplinary action.

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Contact Information
Please provide your preferred contact information below. Your identity will be held confidential. It will not be disclosed to the individuals or group in question. Your contact information allows us to conduct a more thorough investigation by allowing us to ask follow up questions.
Name
Email
Phone Number
Type of Incident (select all that apply)
Hazing Destruction of Property Theft Fighting Harassment Alcohol Violation Sexual Assault Institutional Rule Violation Other
If Other, Please Describe
Incident Information
Student Organization(s) Involved
Names of Student(s) Involved
Date
Time
Location
Was alcohol involved in this incident?	Yes     No     Don't Know
Was anyone hurt or injured during this incident?	Yes     No     Don't Know
Were the police involved?	Yes     No     Don't Know
If so, what was the report number?
Description of the Incident
Please provide as much detail about the incident as possible. Be as specific as you can be including names where necessary.

Updated 04/26/2013
Comments to Office of the Dean of Students | 100 West Dean Keeton A5800 | Austin, Texas 78712-1100
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