Office of Information Security

West Chester University


Incident Report

If you believe you have been involved or are aware of a computer incident, please complete the form below. If you have any difficulties filling out the form, you can also send an email to

abuse@wcupa.edu

Contact Information
First Name:

Last Name:
Title:
Department or Company:
Street:
City:
State:
Zip:
Phone:
Email:
Event Information
Date of Incident:
Time of Incident:
Type of Incident:
Suspected Method:

Apparent Source:
Evidence of Spoofing?

Yes No

Loss/Compromise of Sensitive/classified or proprietary information? Yes No
Damage to Systems/data? Yes No
Description: