Skip to main content
Campus Operations Banner

Campus Hazard Notification Form


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

Name: Date Reported:

Email: Phone #:

Building/Location Description:

Room/Office Number: Level of hazard:

Have you reported this previously? Yes No

Description of hazard:

I understand that my IP address will be submitted with this form to establish accountability in the event of harassing and/or fraudulent form submissions.

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