Part of UT Health San Antonio

Campus Security Authority Crime Report Form

According to federal law, specifically The Clery Act, previously known as The Student Right to Know and Campus Security Act of 1990, The UT Health San Antonio Police Department is required to report “statistics concerning the occurrence of certain criminal offenses reported to the local police agency or any official of the institution who is defined as a 'Campus Security Authority.'”                    

The definition of “Campus Security Authority”, according the federal law, is as follows: “An official of an institution who has significant responsibility for student and campus activities, including, but not limited to, student housing, student discipline, and campus judicial proceedings.”  

This Federal Clery Act applies to certain crimes reported to the police and other University officials known as Campus Security Authorities. Campus Security Authorities are federally mandated crime reporters. As such, these authorities shall report, on a timely and informative basis, any Act-qualifying crimes that they are made aware of to the UT Health San Antonio Police Department. University Police will use the submitted information to verify the appropriate classification of the crime. Test your knowledge as a Campus Security Authority with a Pre/Post Test directly from the Clery Center.

Crime Reporting Form

Section A: Submission

To send the completed report form electronically, please click on the submit button at bottom of this form. You may also print this form and email it to the Police Compliance Coordinator, Artrecia Hardaway at hardawaya@uthscsa.edu  or fax  it to ( 210-567-6234 ) attention Artrecia Hardaway or mail it to University Police, 7703 Floyd Curl Drive San Antonio, Texas 78229-3900, Attention Police Compliance Coordinator, Artrecia Hardaway.

Section B: Contact Information
Section C: Dates
Section D: Crime Occurrence Location

Please provide building name, address, street name with cross streets or close address, or nearby buildings if it occurred outside. Consult the Act Reportable Locations as necessary.

Section E: Reported Crime

Check the box that best indicates the crime you are reporting. As needed, please refer to Reportable Crimes for crime definitions.

The following crimes need only be reported if the victim(s) of the reported crime was/were targeted specifically because of bias/prejudice against the victim.

Please provide a brief description of the reported crime (what happened?) to help us classify it.

Section F: Hate Crime Reporting

Was the crime reported in Sectin D motivated by bias (was the victim specifically targeted because of prejudice i.e. Hate Crime)?

Section G: Referrals

Certain student and employee violations referred to Student Affairs, Human Resources, etc. must be reported. These reportable law violations include:

If a liquor, drug, or weapon law violation referral is reported, the corresponding number of persons referred must be entered. Refer to the Clery Act Reportable Arrests and Referrals section to view reportable crime definitions.

Section H: Secondary Reporting

Law Enforcement agency(s) the incident has also been reported to:

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Section I: General Information

Crime Reporting – It is the policy of UTHSC University to ensure that the victims and witness to crimes are aware of their right to report criminal acts to the University Police Department (210-567-0671). CSA’s should ask reporting party if they would like to report the crime to University Police. If the reporting party wants University Police contacted, the CSA should contact University Police and if the CSA can verify that University Police responded and took a police report, then it is not necessary for the CSA to complete and submit this form. However, if the CSA can’t verify that University Police responded and took a police report, then the CSA must complete and submit this form.

Anonymity – If a crime reporting party request anonymity, this request must be honored to the extent permitted by law. Accordingly, no information should be included on this form that would personally identify the victim without his/her consent.

 

Sexual incidents – CSA’s reporting a victim (student) reported incidence of sexual violence or harassment are encouraged to refer the reporting student to Student Counseling Services at 210-567-2648 CSAs reporting a victim (employee) reported incidence of sexual violence or harassment are encouraged to refer the reporting employee to the CARE Employee Resource at 210-567-2273