Dean of Students
Dean of Students Reporting forms

Reporting Forms

Emergency Situations - Dial 911

In the event of an emergency or if you feel your personal safety is threatened, do not use these forms.  Please contact the UW-Whitewater Police Services by dialing 911

Federal and state laws require faculty and staff to report any information about sexual misconduct they are made aware of, regardless of the location. To report a sexual misconduct incident to the Dean of Students Office (Andersen Suite 2130), please choose the appropriate form below, providing as much information and detail as possible.

Sexual Misconduct Reporting Form

For more information, please visit: UW-Whitewater's Sexual Misconduct Policy

CARE Team Reporting Form

Members of the UW-Whitewater community may use this form to report concerning behavior directly to the CARE Team.  The Reporting form is securely transmitted to the CARE Team Case Manager in the Dean of Students Office. The Case Manager reviews all concerns submitted and shares them with the CARE Team members.  CARE Team members review the reports and determine an appropriate course of action for each situation using team protocols, professional knowledge and past precedent. 

The Case Manager may contact individuals who have submitted a concern to obtain more detailed information. All concerns will be investigated and action will be taken to address them in a manner that provides a high level of care for each individual and protects our campus community.  Due to FERPA privacy constraints, members of the CARE Team will not be able to share information about the team's response with individuals who report concerns.

Hate and Bias Reporting Form

What is a Hate/Bias Incident?
Any physically or verbally harmful act that is motivated by (or appears to be motivated by, in whole or in part) any quality/qualities of someone's identity (such as race, religion, gender, sexual orientation, disability, etc).

What is the purpose of this form? 
The purpose of this form is to monitor the occurrence of hate/bias incidents both on and off campus. Submitting this form may or may not result in criminal or university action, depending on the type of incident and the victim's/target's willingness to take further action. Submitting this form does not constitute a formal complaint.

Information obtained through these reports will assist UW-Whitewater in responding to and tracking incidents of bias and hate. Reports may be anonymous; however, anonymous reports may limit the university's ability to respond to the incident. If you prefer to report an incident in person, please contact the Chief Equity, Diversity, and Inclusion Officer in Hyer Hall 425.  

If you need to report a crime not related to a hate/bias incident, you can contact the UW-Whitewater Police at 262-472-4660.

This form should be used only by a Campus Security Authority (CSA) on campus. To report robbery, aggravated assault, burglary, motor vehicle theft, arson, or other crimes that have been reported to you, please choose the appropriate form below. If the crime is regarding sexual misconduct (sexual assault, dating violence, domestic violence, stalking), please use the Sexual Misconduct Reporting Form. This form is delivered directly to the UWW Police Department. If you are a victim or observe the following crimes listed, contact the police immediately at 262-472-4660 or dial 911.please choose the appropriate form below, providing as much information and detail as possible.

Clery Act Crime Reporting Form 

The University of Wisconsin System Administrative Policy 136 requires all students to provide disclosure about felony convictions or expulsions, dismissals and/or suspensions from a post-secondary institution for non-academic reasons prior to participating in a study away program, domestic travel or an overnight stay that is related to the course curriculum.  This policy seeks to ensure that all UW System institutions provide a safe and secure environment for members of the university community. Students who disclose a prior felony, conviction or post-secondary disciplinary record will not be automatically barred from participating in the programs/activities. All disclosures will be reviewed by the Institutional Review Committee, who will be responsible for rendering a decision regarding the student's eligibility to participate.  If you are traveling, please submit this form two weeks prior to your scheduled departure date.

Policy 136 Disclosure Reporting Form

Members of the UW-Whitewater community can use this form to report a concerning behavior in relation to the COVID-19/Coronavirus pandemic.  This could include issues relating to face coverings, social distancing, etc on campus.  The Dean of Students Office will review each report and follow up or pass on the report to the appropriate entity.  If this is a health or informational concern or question please contact the UW-W COVID-19 website:

COVID-19 Behavioral Compliance Form 


Andersen Suite 2130
Phone: (262) 472-1533
Fax: (262) 472-1275

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