» CERT Incident Notification Form

Please use the form below to report an incident of possible bias, hate, or discrimination. You may submit the form anonymously, by leaving out contact information, if you prefer. The form will be forwarded directly to the CERT team so that they may review the incident, advocate for and empower those affected, inform and educate the campus community, and promote civility and respect. Key campus personnel may be included to develop an appropriate plan to support affected community members’ success and ensure the safety and well-being of the campus community.

NOTE: If your concern is related to an EMERGENCY where there may be an imminent risk to the safety of others, the CERT Incident Notification Form is not the appropriate way to let us know about your concern.  Please directly call one of the following offices:

Public Safety - (714) 997-6763 (all calls after regular business hours and on the weekends should be directed to Public Safety)

Dean of Students Office - (714) 997-6721 (regular business hours)

Housing and Residence Life - (714) 997-6603 (regular business hours)

If you are dealing with a life-threatening emergency, call 911 immediately.

* Please check the box(es) that best describe your role in the Chapman community:

Upload up to 3 photos of incident (optional)




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