Incident Reporting Form
Incident Reporting Form

The Confidential Incident Reporting site allows Buffalo State College community members (students, staff, faculty and their significant others) to let the Office of the Dean of Students know about non-emergency events they have experienced or witnessed. This option allows people to express what happened in a confidential way that does NOT constitute a formal report to law enforcement or any judicial/administrative actions.

(To initiate a formal process, please contact either the Office of Equity and Campus Diversity 716-878-6210 or University Police Department 716-878-6333. The University Police Department has an anonymous reporting site for sexual assault:

The information in this form goes to the Office of the Dean of Students and will not be shared except in aggregate, non-identifiable form. 
For more information on the Office of the Dean of Students, please visit:

Buffalo State College takes the reports made through this site seriously. Please make your report as accurate, complete and truthful as possible. Every effort will be made to evaluate your report promptly, however, the timing and manner in which the University addresses the report will vary depending on the information provided and whether you wish to remain anonymous. The College does not guarantee it will respond to reports. 

The information contained in this report will become part of the College’s formal record-keeping.  Reports may be available to the students to which they pertain under The Family Educational Rights and Privacy Act (FERPA). FERPA is a Federal law that protects the privacy of student education records. 

Please complete this form to the best of your ability. The most important aspect is the Narrative. When writing your narrative please provide:

Type of incident (write any/all that apply):
- Bias Motivated
- Discrimination
- Harassment
- Hazing
- Intimate partner abuse
- Physical assault
- Sexual assault
- Sexual harassment
- Stalking
- Unfair treatment
- Other
- Uncertain
Your Information
Date & Time
Who’s Involved
Clear Respondents
Press 'Add' to record this person
File Cabinet
Upload File
To attach files drag & drop here or select files from your computer…