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Bias Incident Reporting Form


If you have been the subject of or a witness to a bias incident, please complete and submit this report. The filing of a Bias Incident Report should be taken seriously and by submitting a report, you are attesting that the information provided is true and correct to the best of your knowledge. Submitting information about bias incidents is important. It provides the notice necessary for the University of Tennessee, Knoxville to accurately monitor and appropriately respond to activity that negatively impacts the diversity and well-being of our academic community.

*Do not use this form in the case of an emergency. If this is an emergency, please dial 911, UTPD at (865) 974-3111, or KPD at (865) 215-7000.

Reporter Information

 
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Witness, Complainant (experienced the incident), Respondent (reported perpetrator of the incident)
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Undergraduate Student, Graudate/Professional Student, Faculty, Staff, Visitor
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i.e. Name of residence hall, academic building or class, social media, Zoom, email, etc.

Involved Parties

Please include as much information as possible for each person involved in the incident.

Involved party 1

Incident Report

Please select all categories that apply below.

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Nature of Bias:(Required)
You must make at least one selection.
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Did anyone witness the incident?(Required)
You must make at least one selection.
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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