Incident Report - University of Rochester Traveler Abroad

To be completed by University of Rochester program/organization leaders or individual travelers.
This form provides a uniform procedure for documenting the (Who, What, When, Where) of reportable student/traveler incidents and crimes.
Complete this form thoroughly for any crimes or incidents (including hospitalizations, serious/major illness, alcohol violations, robberies, assaults, etc.) affecting any UR student, faculty, or staff member on sponsored or supported travel abroad.
If you are a student seeking assistance related to an incident of sexual misconduct and do not want to make a formal report about the incident to the University, please review your options for seeking support and making an anonymous report on the Student Sexual Misconduct website here.
If this is an ongoing emergency, immediately contact the University's Director of Global Travel Risk Management for resource support:
Director of Global Travel Risk Management
24/7 Cell: +1 585-857-1168 (iMessage, WhatsApp, Viber) 
WeChat ID: URtravelManager
For additional support, please contact Public Safety or the Emergency Preparedness Manager:
UR Public Safety
+1 585-275-3333
Emergency Preparedness Manager
24/7 Cell: +1 585-353-4700

Were there witnesses? *
Were clinic/hospital/health practitioners consulted? *
Was there medical treatment required? *
Were host university authorities notified? *
Was the local police notified? *
Was a report filed? *
Are you already in communication with a University of Rochester faculty or staff member?