Bluffton University Incident Report

As you complete the Bluffton University Incident Report form, we ask that you fill in all fields as completely as possible. Remember to record only factual information as witnessed by yourself or others. Once you have completed all fields, hit the send button. All information will then be sent to Student Life. If you have questions or concerns, feel free to contact Student Life at 419-358-3247.

Report filed by (Name, Hall & Room, Box): *
	* Required information
Date & Time of Incident:	*
Location of Incident:	*

Type of Incident:	*
Those Involved (Name, Hall & Room, Box): *

Description of Incident (Please be as detailed as possible): *

Action Taken: *