Education Abroad Incident Report

Education Abroad Incident Report Form

Thank you for submitting an Incident Report Form to Education Abroad. Please follow the instructions below based on the nature of the circumstance.
  • In addition to this form, please submit a referral form to UConn depending on the nature of the incident. You may do so at

    Please report any threat of harm immediately to the local authorities and the UConn Police at +1 (860) 486-4800.

    If the incident involves a medical emergency, call CISI Insurance immediately at +1 (312) 935-1703.
  • Name of the individual submitting the incident report
  • Phone number of the individual submitting the incident report
  • If you do not have a phone with you, or prefer a different mode of contact, please input it here (i.e., WhatsApp or Skype, along with your number or username).
  • Role of the individual submitting the incident report
  • Date Format: MM slash DD slash YYYY
    Date on which the incident occurred in the host country
  • :
    The time that the incident occurred, in host location's local time zone
  • The city and country in which in the incident occurred
  • First NameLast Name 
    Please include the first and last names of all individuals involved in the incident, including any witnesses
  • Please provide all details regarding the incident. When did you learn of the incident? What actions have you already taken? What local authorities are involved, if any?
  • Please upload any additional files that you may have to support records of the incident