Incident/Concern Report Form

As part of our ongoing commitment to maintaining a safe and supportive community, Carroll College encourages you to utilize the Incident/Concern Report Form for any concerns or incidents that may arise within our college environment.

This is an internal reporting tool intended to address concerns in a safe, timely, and supportive manner with the goal of connecting individuals to the resources they need. In the case of an emergency, always dial 9-1-1 first!

Choose the report that best matches your concerns. Any reports mistakenly submitted to the incorrect office will be directed to the appropriate office by the Dean of Students.

  • Personal concern: Use this form to refer a student who is exhibiting concerning behaviors, struggling with personal or emotional difficulties, etc., that should be brought to the attention of the Carroll College CARE Team.  Carroll employees should complete the Student of Concern form found on MyCarroll rather than this form.
  • Sexual misconduct: Use this form to report any alleged sexual misconduct including sexual contact without consent, sexual assault, dating violence, domestic violence, sexual harassment, and stalking.
  • Bias incident or hate crime:  Use this form to report conduct or speech, which results in harassment, threat, intimidation, or a criminal offense toward a person or group or property, that is motivated--in whole or in part--by the perpetrator's bias.
  • Policy violation:  Use this form to report alleged violations of the Carroll College Student Code of Conduct.  This report is primarily for non-academic behavioral misconduct (e.g. alcohol, housing, theft, assault, vandalism)
  • Accident or other type of incident:  Use this form to report for any accidents, or general incidents. (i.e. falls, car accidents, damaged items, travel incidents, etc.)
  • Concern or Complaint: Use this form to report any other incident or situation that doesn't fit in the other categories listed above.
  • Disability Discrimination: Use this form to report any problems, issues, or concerns with approved accommodations not being complied with or implemented in a way that mitigates disability challenges.

Submitting a reporting form does not automatically start emergency / crisis response, a sexual misconduct process, an investigation, or a formal grievance.  However, based on the information you share, the College may take a form of immediate action to ensure that our community members are safe and supported.

If you have chosen to leave your contact information, a college official may follow up with you to make sure we understand your concern and discuss any next steps toward resolution, as well as identifying possible support options for those involved. Please know that we will treat information you provide with the utmost privacy and share information only on a need-to-know basis.

If you choose to report anonymously, you will be given the opportunity to provide a confidential file code that you may use if you choose to add additional information to your report at a later date. Please note, mandatory reporters (Carroll employees, RAs, Peer Ministers) must provide their contact information.

Once again, thank you for being a member of our community who cares about the environment in which we all learn, live, and/or work.

Personal concerns will be referred to the CARE Team, OR, if you are Carroll Employee, please complete the Student of Concern form in MyCarroll.
Bias incident or hate crime reports will be referred to the Title IX Coordinators.
Policy violations will be referred to the Dean of Students Office.
Concern or Complaint reports will be referred to the Dean of Students Office.
* refers to the individual on which this report is centered
(Carroll employees, RAs, Peer Ministers)

Enter a code name of your choosing above.  When and if you choose to pursue any further action through the College with respect to the materials you submit, provide this code to the Student Conduct Administrator or the Title IX Administrator and they will pull up your information.  Until such time it will be securely and confidentially stored.

If you need to add additional information to your file at a later time, please use the same code name.

In order for the College to reach out to the reporting party, verify receipt of the Report an Incident or Concern form, and offer any additional information and/or support, the reporter's name is needed. A reporting party can also choose to be anonymous, in which case the College's ability to respond will be limited.
Please provide your email address so that we can contact you if we have follow up questions about this report.
Please provide your phone number so that we can contact you if we have follow up questions about this report.

Sexual Misconduct

An Incident of sex-or gender - based harassment, discrimination, or violence

  1. Allows a college official to contact the incident reporter (if name is provided) to confirm receipt of the report and ask if the reporter needs information and/or assistance.
  2. Allows the College to report more accurately the number of offenses/incidents occurring on campus each year. These numbers are reported in our annual campus security report in compliance with the Clery Act; statistics gathered from these forms are also posted on the College's daily crime log. Note: Personal identifiable information is not posted

Sexual Misconduct Resources

If you have questions or concerns about this reporting tool, do not hesitate to contact the Dean of Students at deanofstudents@carroll.edu or (406) 447-5434.

Consult the online version of the Title IX Policy.

Type of sexual misconduct
(e.g. touching of the private body parts of another person for the purpose of sexual gratification without consent)
(e.g. attempted or completed penetration or forced to penetrate through force and/or against the person’ will or where the victim is incapable of giving consent because of mental or physical incapacity)
(e.g. violence, threatened or committed, by a person who has been in a romantic or intimate relationship with the victim)
(e.g. a behavior which involves the abuse by one partner against another in an intimate relationship such as marriage or cohabitation)
(e.g. a course of conduct directed at a specific person that would cause a reasonable person to fear for her, his, or others' safety, or to suffer substantial emotional distress)
PERSON (refers to the individual who experienced sexual misconduct)
* if known
Check all that apply
INDIVIDUAL (refers to the individual who engaged in sexual misconduct against the PERSON)
* if known
Check all that apply

Bias

Bias Incident Acknowledgement

Students, faculty, staff and other concerned community members should use this form to report any incidents believed to be bias-motivated or hate crimes.

  • Bias is defined as a pre-formed negative/prejudiced opinion or attitude toward a group of persons based on their age, race, gender, gender identity, religion, disability, sexual orientation, social/economic status or ethnicity/national origin.
  • A bias incident involves conduct or speech, which results in harassment, threat, or intimidation toward a person or group or property, and is motivated--in whole or in part--by the Perpetrator's bias.
  • A hate crime is a criminal offense committed against a person or property which is motivated, in whole or in part, by the perpetrator’s bias.
  • All bias incidents are not hate crimes although all hate crimes are bias incidents.
(i.e., sexist, racist jokes, slurs, etc.)
What types of identity do you believe this incident was targeting (i.e., was it based on assumptions about race, sexual orientation, disability, etc.)? Please check all that apply.
Check all that apply
In the space below, please describe the PERSON/people in as much detail as possible, including sex, estimated age and physical characteristics.
Check all that apply
* if known
In the space below, please describe the perpetrator(s) in as much detail as possible, including sex, estimated age and physical characteristics.

Policy Violation

Type of incident

Description

* if known
* if known
Please select all that apply
Please provide as much information as possible about the incident (there is no text limit).
If you have any documents that would support your concern (emails, texts, screenshots, pictures), please upload any supporting documentation that you have for this incident.
Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: gif jpg jpeg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 mp4 ogg wav bz2 dmg gz jar rar sit svg tar zip.
Please provide as much information as possible (there is no text limit).
If you have questions or concerns about this reporting form, do not hesitate to contact the Dean of Students at deanofstudents@carroll.edu or (406) 447-5434