Risk Management and Insurance Service Request Form

Risk Management and Insurance works to optimize risk identification, mitigation, and control in all university activities. It protects the university's assets by identifying and analyzing risk exposures, controlling those exposures, mitigating risks, financing losses, and implementing and monitoring risk-management processes. Purpose: This form is to be used by University of Oregon students, staff/faculty only. Departments may use this form to request risk consultation or training session related to insurance and risk management. Please complete the below request form. A response is typically provided within 1-3 business days.

Please indicate todays date

Requestor's Name*

Requestor's email*

Department

Risk Consultation Training or Assessment Request*

Please select all that apply. If selecting Other: you may type a title in this field.

Select or enter value

Additional Details*

Please provide additional details on your request. Example: Group discussion on youth programs with staff considering implementing a youth program next year.

Method of training/consult

Please indicate location (virtual/in person)

Select or enter value

Please provide location of presentation if in person, if not applicable please move to the next question.

Secondary contact name

Secondary Contact email

Please provide a secondary contact email

When would you like this training or assessment?

Please indicate date(s) or a timeline for this request.

I'd like a response by:

Typical response time is 1-3 business days to set up a training or consultation time.

Rush Request?

Please indicate if your department has an immediate need or short turn around request.

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