UMUEquitas

Uganda Martyrs University - Safeguarding & Whistleblowing Platform

Offline Incident Reporting Form

🔒 CONFIDENTIAL - This form must be handled with strict confidentiality

Section A: Reporter Information (Optional for Anonymous Reports)

I wish to remain anonymous: Yes No

Section B: Incident Category

Sexual Exploitation, Abuse, and Harassment (SEAH) Physical Harm (PH) Emotional Distress (ED) Material Loss/Theft (ML) Other forms of harm/risk (OH) Other (specify below)

Section C: Incident Details

Section D: Declaration

I hereby confirm that the information provided above is true and accurate to the best of my knowledge. I understand that this report will be handled confidentially by the Uganda Martyrs University Safeguarding Team.

How to submit this form:
1. Email to: safeguarding@umu.ac.ug
2. Drop at: Office of the Dean of Students, Main Campus, Nkozi
3. Call hotline: +256700123456
After submitting, you will receive a tracking code to monitor your report.