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Bias Report Form


Do not use this form to report an immediate threat to yourself or others in the campus community. If you require emergency assistance, please dial 911 for the police.

Please use this form to report an incident to the Bias Education and Support Team. This form can be completed by either targets of bias-related incidents, witnesses, or those indirectly impacted by them (e.g.family and friends). Include as much detailed information as possible.

You may choose to submit this form anonymously; however, not identifying yourself can limit the University's ability to respond to this report, including providing the necessary support to targeted individuals. Therefore, we ask that you include your contact information when submitting a report

Your trust is very important to us, and we will make every effort to respect your privacy. However, in certain circumstances we cannot guarantee anonymity. All reports will be kept private to the fullest extent possible in accordance with federal and state law. The University at North Carolina at Greensboro strives to honor the wishes of reporters, but they may need to take additional actions to protect the health and welfare of impacted individuals and the broader University community.

Reporter's Information

While anonymous reports are accepted, you are STRONGLY encouraged to provide your name and contact information in order for us to most effectively and efficiently address the concerning behavior.

 
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Please provide the name you are most comfortable using
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If you are a student, please provide your ID number
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Provide a brief description of the type of bias you are reporting.
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This field is required.

Involved Parties

Please list all individuals (including yourself) involved and the information of the alleged respondent. If the name/identity of a person is unknown to you, please enter "Unknown Person" as the name in this section and then describe the individual(s) in as much detail as possible below in your narrative.

Involved party 1

Reasons for report

Type of Incident (Check all that Apply)(Required)
You must make at least one selection.
Type of Bias/Hate (Check all that Apply)(Required)
You must make at least one selection.
Duration of Behavior(s)(Required)
You must make at least one selection.
This field is required.
Has this been reported to a police agency?(Required)
You must make at least one selection.
University Follow-up: Please indicate whether you would like for us to to contact you for further follow-up(Required)
You must make at least one selection.
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.

Submission