Incident Report Form

If this is an emergency, please dial 9-1-1

As part of Alpha Psi Lambda's commitment to the health, safety and well-being of our members and campus communities, this form has been created to allow individuals to report incidents of concern. 

While you can report anonymously, the inability to validate the source of the complaint does limit the Fraternity’s ability to investigate and respond.  Alpha Psi Lambda takes reasonable steps to maintain the confidentiality of information submitted to the extent permitted by law. Our ability to investigate allegations of misconduct and to take corrective action may be impeded if your identity is not provided in the complaint. Depending on the nature of the allegations(s) raised, conducting a fair and complete investigation may require that the full details of the incident, including your identity be shared. In those instances, all parties will be advised of the Fraternity’s policy against retaliation for making complaints.  If you wish to remain anonymous please do so by omitting the contact information and checking the box that you are providing the information anonymously.

Alpha Psi Lambda may be required to provide information to University and/or local law enforcement related to alleged violations of University policies or local, state, or federal laws.

Please fill out all applicable fields providing as much information as possible. This will allow the National Office the opportunity to be able to address the situation and provide the appropriate support.

First Name
Last Name
Phone Number
Check this box if you prefer to report this anonymously:

Indicate your relationship (if any) to the Fraternity:

Chapter or campus involved *
Example: Alpha Chapter or The Ohio State University
Type of Incident *

Name of members involved
Describe the incident *
Please include as much detail as possible, including the specific date, time and location of the incident
Supporting documentation
If you are in possession of any emails, text messages, pictures or social media posts in connection with this report, please attach them here.