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Section Menu
Office of the Chancellor
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Office of the Internal Audit
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Ethics Hotline Online Reporting
Ethics Hotline Online Reporting
Section Menu
Office of the Chancellor
Office of the Internal Audit
Board of Trustees
Incident Web Report
Step
1
of
6
16%
Location Information
Location and Name
(Required)
Address
(Required)
City
State / Province / Region
ZIP / Postal Code
Reporter Information
Would you like to provide your name?
(Required)
Yes
No
Name
(Required)
First
Last
Relationship to the College
(Required)
Student
Faculty
Staff
Vendor
Community Member
Other
Phone
(Required)
Email
(Required)
Incident Details
What incident type best describes the issue?
(Required)
Accounting/Audit Irregularities
Conflicts of Interest
Customer Relations
Discrimination
Employee Relations
Falsification of Company Records
Fraud
Fraudulent Insurance Claims
Improper Loans to Executives
Kickbacks
Policy Issues
Product Quality Concern
Release of Proprietary Information
Retaliation of Whistleblowers
Safety Issues and Sanitation
Sexual Harassment
Substance Abuse
Theft of Cash
Theft of Goods/Services
Theft of Time
Unauthorized Discounts
Wage/Hour Issues
Workplace Violence/Threats
When did the incident occur?
(Required)
MM slash DD slash YYYY
Where did the incident occur?
(Required)
How do you know about the incident?
(Required)
Heard from others
Involved
Overheard
Witnessed
Unknown
Don’t wish to answer
Other
Is any supporting information available?
(Required)
Yes
No
Upload supporting documentation (documents, emails, voicemail, photos, etc.)
(Required)
Drop files here or
Select files
Max. file size: 50 MB.
Provide a detailed description of the incident
(Required)
(Please provide as much detail as possible including times, dates, places, and names.)
Responsible Individuals
Responsible Party 1
Do you know the individual's name?
(Required)
Yes
No
Name
(Required)
First
Last
Title
Description of the individual
(Required)
Be as specific as possible.
Add another responsible party?
(Required)
Yes
No
Responsible Party 2
Do you know the individual's name?
(Required)
Yes
No
Name
(Required)
First
Last
Title
Description of the individual
(Required)
Be as specific as possible.
Add another responsible party??
(Required)
Yes
No
Responsible Party 3
Do you know the individual's name??
(Required)
Yes
No
Name
(Required)
First
Last
Title
Description of the individual
(Required)
Be as specific as possible.
Management Notification
Was management notified?
(Required)
Yes
No
Manager 1 Information
Name
(Required)
First
Last
Title
(Required)
Date Notified
(Required)
MM slash DD slash YYYY
Action Taken
Add another notified manager?
(Required)
Yes
No
Manager 2 Information
Name
(Required)
First
Last
Title
(Required)
Date Notified
(Required)
MM slash DD slash YYYY
Action Taken
Add another notified manager?
(Required)
Yes
No
Manager 2 Information
Name
(Required)
First
Last
Title
(Required)
Date Notified
(Required)
MM slash DD slash YYYY
Action Taken
Other Involved Parties
Is anyone else involved or aware of the incident?
(Required)
Yes
No
Name or Description
(Required)
How is the individual involved?
(Required)
Attorney
Co-Worker
Regulatory Body
Alleged Victim
Witness
Unknown
Other
Do you know the individual's name?
(Required)
Yes
No
Name
(Required)
First
Last
Title
Description of the individual
(Required)
Add another involved party?
(Required)
Yes
No
Name or Description
(Required)
How is the individual involved?
(Required)
Attorney
Co-Worker
Regulatory Body
Alleged Victim
Witness
Unknown
Other
Do you know the individual's name?
(Required)
Yes
No
Name
(Required)
First
Last
Title
Description of the individual
(Required)
Add another involved party?
(Required)
Yes
No
Name or Description
(Required)
How is the individual involved?
(Required)
Attorney
Co-Worker
Regulatory Body
Alleged Victim
Witness
Unknown
Other
Do you know the individual's name???
(Required)
Yes
No
Name
(Required)
First
Last
Title
Description of the individual
(Required)
