WeCARE Reporting Form (Behavior Concerns, Harassment Reports, Security Concerns, etc)

Background Information

Your full name:

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Or, you may write Anonymous

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

This field is required.

Urgency of this report(Required):

This field is required.

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If this is a critical security threat, please call (229) 468 2241.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

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Specific location:

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide. For non-students, please list an SSN or Drivers License number in the block labeled SID (Student ID #) if available. If you do not know the student or employee ID#, please complete the form without this information.

Full Name of Person Involved

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Questions

Please provide a description of the incident/concern using specific concise, objective language (Who, what, where, when, why, and how). Provide as much detail as you have available at the time of this report.(Required) This field is required.

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.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission