BERT Report

BERT Alert

Welcome to BERT Alert. The Behavioral Evaluation Response Team will review the submitted report at its regularly scheduled Thursday afternoon meetings. If this requires immediate attention, please contact Public Safety at extension 5777 on the Utica campus and extension 7270 on the Rome Campus or from off-campus at 315-731-5777. While we do our best to maintain confidentiality, certain circumstances may require disclosure to other necessary and appropriate individuals.

Your full name:

Your position/title:

Your phone number:

Learn more

If we need additional information please provide a contact number

Your email address:

Email address must be of a valid format.

Where do you work?:

Date of incident(Required):

This field is required.

Time of incident:

Involved Parties

Name of Student

Please tell us if the student is male; female; gender non-conforming

Identifying info

Please provide M # of the student

Questions

What has occurred to prompt you to notify BERT? Please be specific about actual behaviors that are of concern.(Required) This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

BERT Alert

Involved Parties

Questions

Supporting Documentation

Submission