Stoner Health & Counseling Center
Stoner Health & Counseling Center
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Report University Related Conduct Violations/Incidents on the Incident Communication Form (ICF).

Students, Faculty, and Staff:

Directions for completing an Incident Communication Form (ICF):

Involved Parties:

Select the type of involved party (Individuals or groups) by clicking the appropriate box.

Under the "Name" box, type the last name of the person you are looking for.  A list of active students/staff member names will populate below the box for you to choose the appropriate person.  Next, under the "Role" box, select the role of the person selected.  There are 3 options: Responding party or person accused of violation; Reporting party or person identified as victim; or other (witness).  If additional Responding party or Reporting party members are involved, click the "+ Add another" link and complete the same steps as above.

Incident Information:

Choose the type of incident or report form you'd like to submit. There are 4 types of forms available.  

1. FYI is general incident form that should be used when something occurs that is NOT a violation of the Student Code or Federal/State/City law.  These may include items like vehicle damage, lock outs, or other notifications that should be documented that may lead to other issues.

2. Conduct is any violation of Federal/State/City/University policies

3. Title IX is any violation of Heidelberg's Sexual Discrimination Policy

4. Accommodations are supports or services provided on Heidelberg's campus so qualified students with disabilities have equal access and opportunities to benefit from classes, programs and/or campus activities. Further information about accommodations at Heidelberg can be found under Accommodations.

Once an Incident Type has been selected, specific questions will populate below.  Complete the information boxes as directed on the form.  If there is not a specific box that addresses your need, please include that information in the "Incident Details" section of the form.  

Supporting Documentation:

Once all involved party and incident information is provided, this section of the ICF allows for any supporting documentation to be uploaded, including medical documents, accommodation forms, incident pictures, text messages, emails, etc.

Things to remember:

  • Fill out the form as soon as the incident is over.
  • Write factual statements - leave out opinions unless backed by fact.
  • Correctly spell all names of person(s) involved.
  • Make sure all addresses and phone numbers are correct.
  • Write in complete sentences and spell all words correctly.
  • Try not to use too many "he/she" or their plurals - use names.

Contact Information

Campus Center

419-448-2041

Our Team

Janelle Baldosser
Director of Health Center & Counseling
Campus Center
419-448-2042
Baldosser
Jenifer Bayer
Nurse
Campus Center
Autumn Crawford
Graduate Assistant
Crawford
Rebecca Gosche
Assistant Director of Health,Counseling & Disabilities Center
Campus Center
419-448-2041
Rebecca Goshe
Karen Raber
Counselor
Campus Center
Karen Raber
John Sharp
Assistant Director of Counseling
Campus Center 134
419-448-2898
john sharp
Julia Yingling
RN, Stoner Health Center
Mary Ziegler
Counselor
Mary Felton