Behavioral Incident Reporting Form

 

In the event of an EMERGENCY, please do not use this form.  Call LSUE Police (337-550-1225) or call 911.

 

Please use this form to report any behavioral misconduct violation of the LSUE Code of Student Conduct. Please see secton 10.2 of the LSUE Code of Student Conduct to reference specific violations of behavioral misconduct.

Disclaimer: Upon completion and submission, this form or inform nnotheratiein may constitute an educational record of any student(s) referenced, and is protected from disclosure except in some limited circumstances.  As an educational record of a student, that student may have a right to review the form.  The University will endeavor to maintain the information contained in the form as private, to the extent required by the law. Questions regarding this form and its completion or use should be addressed to studentaffairs@lsue.edu.

Involved Parties

Please list the individuals involved, including witnesses and victims if there are any.
Please provide the full name and student ID number of all students involved. If there are multiple students involved, list them on separate lines.
Incident Description
Please indicate any potential witnesses in the report below. Again, include as much detail as possible.
Did Police respond?
Did EMS (Ambulance or Fire) respond?
If incident occurred in student housing, was Residence Life staff contacted?
Supporting Documentation

Please send any pictures or other documents that support this report to studentaffairs@lsue.edu.  Supporting documentation may include pictures, screen shots, reports, emails, etc.