CSUF Police Department Behavior Concern Report

THIS FORM IS FOR NON-EMERGENCY USE ONLY

If the situation is emergent, urgent, or the threat of violence is imminent or actively occurring, do not use this form; instead, call 911 or (657) 278-2515.

Please report disturbing, threatening, or violent behavior of the individual to CSUF Police Department via this form.

For use by current CSUF staff and faculty only.

Please complete the form link below if the behavior is a potential violation of the Student Code of Conduct and involves hazing, bullying, alcohol, drugs, or a disruption.

Student Conduct Referral

Please note that submissions using this form might not be reviewed immediately. All submissions will be sent to the CSUF Police Department command staff for review.

Remaining anonymous may limit our effectiveness in dealing with the concerning behavior.

Your Information

Name (First & Last)

Date of Submission

mm/dd/yyyy

Contact #

Phone

Email Address

Department or College

The department or college you work for

Supervisor Name

Incident Details

Date of Incident

mm/dd/yyyy

Name of Person of Concern

Person of concern is student, staff, or faculty?

Describe behavior or situation

What is your concern?

Has action been taken?

Yes

Supervisor/Administrator Notified?

Witness Information

Witness 1 Name

Witness 2 Name

Witness 3 Name

File Upload

Please upload documents or photos that you believe would help provide context, data, or evidence regarding your concern

Drop your files here

Would you prefer to remain anonymous?

Yes

Send me a copy of my responses

Report Abuse