Student Accessibility Services

Climate Response Team Form

What is a Hate/Bias Incident?
Any physically or verbally harmful act that is motivated by (or appears to be motivated by, in whole or in part) any of the following factors: race, religion, ethnic background, sexual orientation, gender, gender identity, or disability.

What is the purpose of this form?
The purpose of this reporting form is to monitor the occurrence of hate/bias incidents both on and off campus. The identity of the victim/target will be kept confidential to the maximum extent possible under applicable state and federal law. Submitting this form may or may not result in criminal or university action, depending on the type of incident and the victim’s willingness to take further action.

Who should complete this form?
Anyone who has experienced, witnessed, or learned of a hate/bias incident should complete this form. You may fill out as much or as little information as you choose, but in order for the University to respond most effectively, it is important to include as much information as possible. Please include your name if you wish to be contacted. If you are under 18 years of age and do not want to make an official police report, do not include your name on this form.

Climate Response Team Form