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Campus Hazard Notification System

Instructions

Fill out the appropriate sections of this form to send your report of a campus hazard situation to the UTA Police Department.

If the hazard represents a life-threatening situation, do not use this form.  Call (817) 272-3003 immediately to contact the UTA Police Dispatcher, 24 hours a day.

Use this form for:

  • physical security issues

  • hazardous materials concerns

  • health-safety concerns

  • areas that are in need of lighting

  • general safety concerns

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Campus Hazard Report Form


Name: Date Reported:


Email: Phone #:


Building/Location Description:


Room/Office Number: Level of hazard:


Have you reported this previously? Yes No


Description of hazard:



Thank you for your involvement in making the UTA Campus a safer place.



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Document No. 109416 [3/13/2006]
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