Incident Report Form Header Image

Safety Incident Report


BEFORE YOU BEGIN: If this is an emergency that involves an immediate risk to health or safety, to reach the Scripps Dean On Call, please call Campus Safety at (909) 607-2000.

While referrals from this form are reviewed by the case management department, it is NOT designed for emergency response situations.

Scripps College accepts anonymous reports; however, submission of a report anonymously may limit the College's ability to investigate the report.

If you have any questions regarding filing an incident report, please contact the Scripps Assistant Dean and Director of Case Management, Dr. Simone Hicks, shicks@scrippscollege.edu, 909-607-8177.

Your full name:
Date/time of incident*
:  
Location of Incident*
Residence Halls*
Other Campus Locations*
Other Locations*

Person of Concern

Please provide as much information as possible about the Student who is exhibiting concerning behavior.

Questions

What is your relationship with Scripps College?*
Has Campus Safety been notified?*

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 1GB maximum total size.
No File Chosen
File uploads may not work on some mobile devices.
Attachments require time to upload, so please be patient after submitting this form.
Cancel
Confirm