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Safety and Wellbeing Portal

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Report an Incident*
Note: user must select one of the following options in order to proceed.
Choose this option to make an anonymous report. By selecting this option, you inform Wentworth Institute of Higher Education (WIN) of the incident. All reports are individually assessed for further action. By submitting an anonymous report, you understand that WIN will not contact you regarding this incident.
Choose this option to make a formal (identified) report. All reports are individually assessed for further action. By selecting this option, you understand and agree that you will be identified* as the submitter of this report, and that WIN may contact you regarding this incident to follow-up or for other action. *The contents of the report, and your identity, will be handled with WIN’s privacy policy.
By selecting this option, you understand and accept that you are not submitting any report to WIN, and no further action will be taken. You can make a report at any later time, if you change your mind.

Submit your information here.

If you choose to submit anonymously, you will have that option at the end of this form.
MM slash DD slash YYYY
Are you reporting for yourself or on behalf of someone else?*
How are you (or the person on whose behalf you are reporting) connected to WIN Higher Education?*
How is the person who committed the unwanted behaviour connected to the person who experienced the unwanted behaviour?*
Where did the incident occur?
on or off campus*
on campus*
MANDATORY Do you believe that any of the following were a factor/factors in the incident? Check all that apply.*
Would you consider the incident to fall into one of these categories?*
Select any/all that apply.

Incident Information

If you choose to submit anonymously, you will have that option at the end of this form.
Do you wish to report this incident anonymously, or submit a formal report?*
Note: user must select one of the following options in order to proceed.
Note: if you submit a formal report, you will be identified as the submitter, and WIN may contact you to follow up. Your details and report will be treated confidentially.
Note: if you submit an anonymous/informal report, you can submit a formal report at a later date, if you change your mind.

CONFIRM

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Your name*
(if applicable)
Your email address*
Note: if you are a student of WIN, we will contact you using your WIN email address [email protected].
Note: WIN may contact you by phone and/or email to follow up with this report.

CONFIRM

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