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About this form

This form is for the IU Bloomington campus only. All information submitted is routed to the Student Involvement and Leadership Center, the Office of Sorority and Fraternity Life, and the Dean of Students Office on the Bloomington campus.

Incident Details

Date of Incident (* required)

Time of Incident (* required)

Location of Incident (* required)

Involved Individuals (* required)

Please provide the names of any individuals or organizations involved in this incident.

Incident Description (* required)

Please provide a detailed description of the incident(s).

Supporting Documents (zip)

Please submit any photos, video, emails, and other supporting documents in a single .zip file. Placing the files in a zip file protects the timestamps on the documents.

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No file selected

Contact Information

First Name

Last Name

VPSA - Hazing Report Form

About this form

Incident Details

Contact Information