Behavioral Intervention Team Incident Report

Student's Full Name:
Student's Last 4 digits of SSN ID:
Student's Email Address:

Your Name:
Your Title:
Your Phone:
Your Email Address:
Your Relation to the Student:

Date of Incident: / /
Time of Incident: :  
Location of Incident:


Please provide a detailed description of the incident/behaviors you have observed. Use specific, concise, and objective language. Forward any additional information to the Office of Student Conduct at the Byrnes Building, Suite 201 and/or any electronic communication/supporting documentation to with the subject heading BIT. Please call 803-777-4333 if you have additional questions.

Any effects/impacts of the behavior?

Any attempts to address the behavior & how the individual responded to the attempts?

Any other information about the individual that might seem relevant?