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Suspected Child Abuse Report Form

If you believe you may have witnessed child abuse on campus, you may either complete this form, call us at (716) 645-2266 or dial campus police 645-2222.


Information About the Incident

Include whether a.m. or p.m.

Check all that apply

Be as specific and detailed as possible to the best of your recollection.

Information About the Victim(s)

Approximate age if unknown

Information About the Abuser


Information About Additional Witnesses


Who Have You Shared This Experience With So Far?



The Office of Equity, Diversity & Inclusion (EDI) and University Police will make every effort to maintain confidentiality except in situations where law, University policy, or the investigatory process requires the release of information.

Providing your name and contact information is optional. If you choose to provide this information, it will assist with an investigation and follow-through. Each complaint will be investigated to the best of the University’s ability, based upon the information provided.

Retaliation against an individual who reports suspected child abuse/inappropriate conduct is strictly prohibited.

Information About You (the person filing this report)--optional