*
Required
Nature of this report
*
required
Please Select…
Academic
Health and Safety
Sexual Misconduct
Behavioral
Emotional
Drugs/Alcohol
FYI
Does this need immediate follow-up?*
If this is an emergency situation, please contact Campus Safety- 605-290-1024 or call 911 ( 9-911 if on a campus landline)
Yes
No
If "FYI" was selected, please identify type of concern in the text box
Date of Incident
*
required
(mm/dd/yyyy)
Time of Incident, please be sure to include am or pm
*
required
Location of Incident*
North Suites
East Suites
Strode
Wellness Center
Student Center
Nurses Building (NU or Southeast Building)
Main Building (Administration Building)
Convent
Library
Cafeteria
Career Learning Center (CLC)
Fairmont Campus
Off Campus
Student Name
*
required
Description
Please provide a detailed description of the incident/concern using specific, concise, objective language.
Is there anything else you would like the C.A.R.E Team to know?
First
Last
Phone Number
Position/Title
preferred e-mail