Incident Report Form

Instructions: The Incident Report can be completed by any member of the University community to report on campus crimes, serious safety hazards, medical emergencies, injuries occurring on campus or teaching sites, behavioral problems, Student Guidebook violations, and other security issues. If you have any questions related to completing this report, please feel free to contact the Director of Facilities Management, Rich Sorenson (847-947-5601) for clarifications.

Specific Instructions:

Several critical pieces of information must be completed as part of this report.

Names of Individuals Involved: The name of any person or persons involved in the incident. If more than one person is involved, i.e., two individuals are injured by a car in the parking lot, include information on both individuals in the report.

Status: If known, indicate the status of the individual(s) involved. If the individual involved is faculty or staff, provide title and department.

Description of Incident: Provide a factual description of what took place. Be as specific as possible, for example, for thefts provide a description of what was stolen including serial numbers of property if available.

Description of Action: Describe what action was taken, i.e., police called and took report, or paramedics called and attended victim.

Submitting Incident Report:

Reports will be distributed to other departments depending on the nature of the incident. Incident departments owners are described below, including contact information as needed for questions or follow up. Reports will be distributed on to other departments depending on the nature of the incident as follows:

Student Affairs: Incidents related to student behavior/violations of the Student Guidebook (312) 261-3162
Human Resources: Incidents involving employee injuries/illnesses or harassment (847) 947-5610
Facilities Management: Incidents related to public safety, physical plant issues, thefts (847) 947-5601

Emergency Procedures:

Life-threatening situations, medical emergencies, crime or fire: DIAL 911 IMMEDIATELY AND DIRECTLY

Physical Plant emergencies should be reported immediately to Physical Plant Department. At Field Sites, please contact the appropriate authority in charge of the site hosting the class or event to report physical plant issues.

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