Behaviors of concern include any disruptive, disturbing or destructive behaviors demonstrated by anyone on campus. These may include emotional trouble, unusual or bizarre behavior, destructive behavior to self or others, substance abuse, suicidal tendencies, eating disorders, hostility, harassment, aggression, abuse or risk taking.

First Name

Middle Initial

Last Name

Email

Your Role

Phone Number

* Date of Concerning Behavior

Time of Concerning Behavior

* Location of Incident

Specific Location or Room Number of Incident

Involved Parties

Please list as much of the following information for each individual involved as you know or are able to recall.

Individual 1 Name

Individual 1 ID Number

Individual 1 Gender

Individual 1 Date of Birth

Individual 1 Phone Number

Individual 1 Email Address

Individual 1 Involvement Role 

Individual 2 Name

Individual 2 ID Number

Individual 2 Gender

Individual 2 Date of Birth

Individual 2 Phone Number

Individual 2 Email Address

Individual 2 Involvement Role

Individual 3 Name

Individual 3 ID Number

Individual 3 Gender

Individual 3 Date of Birth

Individual 3 Phone Number

Individual 3 Email Address

Individual 3 Involvement Role

Reason(s) for Report

* PLEASE PROVIDE A DETAILED DESCRIPTION OF THE INCIDENT OR CONCERN USING SPECIFIC, CONCISE, OBJECTIVE LANGUAGE. (PLEASE BE PROFESSIONAL, ACCURATE AND FACTUAL. RECITATIONS OF OBSERVATIONS AND FACTS ARE MORE USEFUL THAN CHARACTERIZATIONS OR LABELS.)

Check all that apply

Behaviors of Concern

Criminal Behavior 

Student Code of Conduct

Information Report

Harassment/Discrimination

HOW WOULD YOU LIKE US TO FOLLOW UP WITH YOU? 

SUPPORTING DOCUMENTATION

PHOTOS, PHOTOS, VIDEO, EMAIL, AND OTHER SUPPORTING DOCUMENTS MAY BE ATTACHED BELOW.
Add one file per "Choose a file" button. You may add up to 6 files, if needed.

Please call campus security at (605)367-7847 or call 911.

Building Addresses/Points of Contact

Mickelson Center
2320 N Career Ave. Sioux Falls, SD 57107

Health Center
2300 N Career Ave. Sioux Falls, SD 57107

Technology Center
2205 N Career Ave. Sioux Falls, SD 57107

This is just a space holder!

Wood Center
2000 N Career Ave. Sioux Falls, SD 57107

HUB
2001 N Career Ave. Sioux Falls, SD 57107

* Is there a reason to believe that there is an immediate threat or danger to individual or member of the campus community?