University of Wisconsin-Milwaukee
Hate/Bias/Incident Report Protocol

It is the intention of UWM to support a campus climate that is respectful and supportive of all who work, live, study or participate in activities or events in the campus community.

Report An Incident at UW-Milwaukee

The University of Wisconsin-Milwaukee defines a hate or bias-motivated incident as any disruptive conduct (oral, written, graphic or physical) that is against an individual, or individuals, because of their actual, or perceived, race, color, national origin/ancestry, religion, sex, age, disability, sexual orientation, gender identity/expression, veteran and National Guard status, marital status, pregnancy, political affiliation, or arrest/conviction record. If you believe the incident involves criminal conduct, please call 911 or 9-911 (UWM campus police) from a UWM phone, in addition to completing this form.

The University of Wisconsin-Milwaukee urges all members of the UWM community to report any hate/bias incident that has occurred on 1) UWM property, buildings or housing; and/or, 2) UWM sponsored events or activities, regardless of location. Please complete the form below to help us investigate this incident and maintain safety on campus.
This reporting process is designed to maintain the privacy of those who choose to use it: to that end, information provided by you will be kept confidential to the extent possible unless you authorize its release for investigation and/or follow-up. If you wish to remain anonymous, please be advised that you will not be contacted by UWM regarding any follow-up related to this report.

* Indicates required information.

*I would like to be contacted regarding this incident. Yes
No, I wish to remain anonymous
Today's Date: 10/17/2017
Your Name: First Name: Last Name:
Address 1:
Address 2:
City:  State:  Zip:
Phone:  - (414-2290000)   
E-Mail:
Relationship to UWM:

Incident/Event Information

Date and Time of Incident: Date:(mm/dd/yyyy) Time: (hh:mm)  AM PM
*Has this incident happened on more than one occasion? Yes
No
Don't Know
Recurring
*Relationship to the incident: I directly experienced the incident
I have knowledge as a direct observer of the incident
The incident was reported to me by someone else
*Incident/Event Location:
*Type of Incident/Event: (Please select all the categories that apply to the event if any)
Damage or Destruction of Property
Physical Harassment or Assault
Verbal Harassment
Phone Harassment
Written Harassment (non-electronic)
Electronic Harassment/Threat (email, blog, text, etc.)
Graffiti
Sexual Assault (unwanted sexual contact)
Intimidation
Vandalism
Other:  
*Nature of Incident/Event: What bias or protected status was the focus of the incident?
(Please select all categories that apply to the event if any)
Age
Arrest/Conviction Record
Color
Disability
Ethnicity
Gender Identity/Expression
Marital Status
National Guard, State Defense, or Other Military Membership
National Origin/Ancestry
Political Affiliation
Pregnancy
Race
Religion
Sex
Sexual Orientation
Veteran Status
Detail Description of Incident/Event: (Please include all the pertinent facts, behaviors, comments, gestures, markings, clothing, or other distinguishing characteristics associated with your experience or observation of the incident/event. For hard copy forms, please attach additional sheets if necessary. You may also upload any camera photos, short video clips, etc.)



(The maximun file size to upload is 80 Mbytes per file.)

Description: File Name:
Description: File Name:
Description: File Name:
Description: File Name:
Description: File Name:
Was anyone physically injured? Yes
No
Don't Know
Please explain [If yes]:
Did you or anyone witness the event? Yes
No
Don't Know
Name(s) (If known): (include any contact information available; name, address, phone number)


What effect did this incident impact have on your perception of UWM's climate?


Information on Person(s) Involved

Information on Person (1) Involved:
Name(s)of Persons Involved [If known]: (Please include any contact information available; name, address, phone number)


Relationship to UWM:



Additional Information: (Any additional information that you would like to provide.)

Once you click on the "Submit to EDS" button below, you will receive a confirmation number. If you requested follow-up at the beginning of this form, you will be contacted within 3 business days (7:45-4:30 M-F), which may include an option to meet and discuss a plan of action to resolve this unfortunate matter. If you wish to remain anonymous, please be advised that you will not be contacted by UWM regarding any follow-up related to this report.

If you are the victim of a hate or bias-related incident, or if you witnessed a hate or bias-related incident, please do the following to document the incident as best you can:

  • If you experienced a written slur or discovered graffiti, do not erase the text. The police will need to see it.
  • If you have a camera or cell phone camera, take a picture of the evidence, any physical injuries sustained, license plate, or anything else relevant.
  • If the incident was verbal, please write down exactly what was said to the best of your recollection.
  • Retain any contact information you may have received from possible witnesses.
  • Speed and accuracy are critical, so please act immediately!
Campus Safety: Phone: 414-229-9911 or 9-911
University Police: (non-emergency): Phone: 414-229-4627
Dean of Students Office: Phone: 414-229-4632
Office of Equity/Diversity Services: Phone: 414-229-5923
Women´s Resource Center: Phone: 414-229-2852
LGBT Resource Center: Phone: 414-229-4116
Norris Health Center: Phone: 414-229-4716