Report an Incident

In the event of an emergency that requires immediate intervention,
call 5911 or 281-290-5911.

Your Personal Information (Optional) Individuals are allowed to make anonymous reports, however, if a name is not provided it may hamper the team's ability to seek follow-up information that may be critical in determining an appropriate course of action. If a name is provided, the team will provide feedback regarding actions taken.
Your Full Name
Status
if other, explain
Primary Phone
Email
Address
Incident Information
Urgency of Report
For critical issues, call 5911 or 281-290-5911 for campus police
Date of Incident
Time of Incident
LSCS Campus
If other, specify
Campus Location (specify room/area)
Internet/Online Issue

Individual's Information Please list individuals involved (excluding yourself), including as many of the listed fields as you can provide.
Individual's Name	Gender	Role	Student ID	Phone

Incident Details
Please provide a detailed description of the incident, paying particular attention to the behaviors of the student/individual. Concrete, specific observations are most useful. Avoid providing judgments, assessments, and opinions. Please describe conversations you have had with the student and any action you have taken regarding this incident.

Upon submission, the Behavioral Incident Report will be delivered to the Behavioral Intervention Team (BIT) for review.