Incident Report Form

If this is an emergency or you require immediate assistance, call 911. This is not an emergency notification system.

If you are reporting an act of unlawful harassment or sexual conduct and are not in immediate danger, please report that here: http://www.dunwoody.edu/students/title-ix/

We appreciate you taking the time to share your concerns/incident with us. Please provide as much information as possible. The more information provided, the more we know how to address the concern or incident.





Please indicate your relationship with Dunwoody College of Technology:

Full name:

Email address:

Phone number:

Please select what type of incident you would like to report: Academic MisconductPersonal MisconductConcerned Persons ReportOther

If other, please explain:

What day did this take place?:

What time of day did this take place?:

For incidents over multiple dates and times, please list them here:

Where did the incident take place? Please be as specific as possible:

Please list the names of all the people involved in this incident:

Please list the names of any witnesses:

What emergency services were called, if any?:

Please provide as much detail as possible about the incident: