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SafeWatch Report

If this is an emergency or requires an immediate

response, please call 290-5911 for campus police.

This online form allows an individual to report information about incidents that adversely affect the campus.

General Information

Your Name:
Phone:
E-Mail:

Please indicate your affiliation to Lone Star College-CyFair:
Student     Faculty     Staff     Visitor/Guest
Please indicate your gender:
Male     Female

Report Information

Please indicate what the incident involved (check all that apply):

Discrimination:
Age
Color
Disability
Gender
National Origin
Political Affiliation
Race
Religion
Sexual Orientation
Veteran Status
Harassment/Threat:
Age
Color
Disability
Gender
National Origin
Political Affiliation
Race
Religion
Sexual Orientation
Veteran Status
Graffiti/Vandalism:
Age
Color
Disability
Gender
National Origin
Political Affiliation
Race
Religion
Sexual Orientation
Veteran Status
Assault:
Verbal
Physical
Sexual
Other
Specify 'Other' below:
Stalking:
Physical
Cyber
Retaliation
Weapon
Other
Specify 'Other' below:
Other:
Classroom Behavior
Demonstration
Hazing
Other
Specify 'Other' below:

Report Description

Date and time of the incident:
Suspectís Name(s): (if known)
Description of Suspect(s): (if name is unknown)
If incident happened to someone else, please provide their name(s): (if known)
What happened? Please describe the incident as clearly as possible.
Where did the incident occur?
List the names of any witnesses who were present: (if known)

By completing and submitting this form, I hereby certify that the information I have provided in this report is true, correct, and complete to the best of my knowledge.

 

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