Bias report form

Please use the incident report form below to report issues to our office. This form should not be used in situations where immediate attention is required. Do not use this form to report an immediate threat. If you require emergency assistance, call 911.

Every effort will be made to evaluate your report promptly, however, the timing and manner in which the University addresses the report will vary depending on the information provided and whether you wish to remain anonymous. The University cannot guarantee it will respond to all reports.

The University of Washington takes the reports made through this site seriously. Please remember that all information contained within this report may become part of the University's administrative record keeping and may be available to the students to which they pertain under The Family Educational Rights and Privacy Act (FERPA) and pursuant to WAC 478-140-018. FERPA is a Federal law that protects the privacy of student education records. More information about FERPA can be found at www.washington.edu/students/reg/ferpa.html#Q2. In making your report, please be professional, accurate and factual. Recitations of observations and facts are more useful than characterizations or labels. All reports will be kept confidential to the extent possible; you also have the option to file anonymously. If you wish to be contacted, please include your name and contact information at the conclusion of this form.

Check all that apply.
Date of incident *
Format: 06/18/2019
If 'other' you may elaborate in the description text field.
Check all that apply. If 'other' you may elaborate in the description text field.
Please provide as much information as you can about the incident, such as names, identifying information, details of injuries, description of harassing behavior, names of witnesses, etc.)
If you would like to be contacted via email for follow-up, please provide your email address. If you do not leave your email address, you will be not be contacted.
If you would like to be contacted not via email, please provide your name and contact information (phone, text, etc) and the best time to contact you.
Supporting Documentation
Photos, video, email, and other supporting documents may be attached below.
Files must be less than 2 MB.
Allowed file types: txt jpg jpeg png 3gp mp4.
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