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Safety and Security
Incident/Accident/Complaint Report Form

For an immediate response please contact the appropriate parties, in addition to filling out this form.
Please see:

* Required fields are marked with an asterisk.










Select the type of Incident




PLEASE DO NOT INCLUDE ANY INFORMATION THAT COULD IDENTIFY THE VICTIM(S).

Race

Sex

Build

Height

Weight

Hair

Eyes

Clothing








Send a copy of this report to your supervisor

Form output will also be e-mailed to libsecurity@lists.berkeley.edu.


4 + 3 =

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Document maintained by: Library Human Resources Department.
Last updated 05/24/17. Server manager: contact.