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Home >EOAA Services: Complaints, Consulting & Reporting: Bias/Discrimination/Harassment Reporting Form

Bias / Discrimination / Harassment Reporting Form

You may use this form to report incidents of possible discrimination or harassment such as graffiti or anonymous phone calls. If you want to discuss the situation or request assistance, please call the EO/AA Office (612/624-9547) to set up an appointment with an Equal Opportunity Consultant. If the incident involves assault, damage to University property, or other potentially criminal conduct, contact the University of Minnesota
Police Department directly (non-emergency: 612-624-COPS [2677]; emergency: 911). The Equal Opportunity and Affirmative Action Office may forward this report to the University of Minnesota Police if the incident appears to be a crime.

To report an incident, please provide information in the boxes below and click SUBMIT.
Date of Incident:	Location of Incident:
Description of incident (include information about any people known or suspected of being involved and their role):
Basis of Discrimination (check any that apply):
Race/Color	Age	Veteran Status
Sexual Orientation/Gender Identity	Disability	Marital Status
Religion/Creed	Gender	Public Assistance Status
National Origin	Unknown	Other:
*Name of Reporting Individual or Office:		Date:
*Campus Address:		*Phone Number:
*Email Address:
* - You are not required to provide your name or other contact information, but the more information you can provide, the more helpful we can be. If you include your name and contact information, you will be contacted for follow-up information and support.

The University of Minnesota is an equal opportunity educator and employer.

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