CSA CRIME REPORTING FORM

To support Meharry Medical College in complying with the federal Clery Act, this form should be used by Campus Security Authorities (CSAs) to report crimes to Meharry Campus Security as soon as possible after they are disclosed. Under the Clery Act, a crime is considered reported when a student, employee, or third party provides information about an alleged incident to a CSA, and the CSA reasonably believes the report was made in good faith. Meharry Campus Security will utilize the information provided to appropriately classify the incident and ensure accurate inclusion in the institution’s annual crime statistics.

Name*
First Last
Department*
Please specify your department.
Phone Number*
Best number to contact you.
Email*

Best email to contact you at.
Date Incident Occured*
MM slash DD slash YYYY
Time of Incident*

: Hours

Minutes

AM/PM
Incident Location/Address*
Where did the incident occur?
Name(s) of the Individual(s) Accused:*
Location Classification (Select One)**
- On-campus (anywhere)
- On-campus student housing
- Off-campus, public property immediately adjacent to campus (sidewalks, streets, etc)
- Off-campus in College leased or controlled space
- Off-campus, not affiliated with and not adjacent to campus
- Unknown location
Victim Name (unless confidentiality has been requested):*
Brief description of the incident:*

WHAT IS THE CLERY ACT?

The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (20 USC §1092(f)) is a federal law originally known as the Campus Security Act. The Clery Act requires colleges and universities that participate in federal financial aid programs to disclose information about crime on and around their campuses, as well as fire statistics that occur in student housing.

The Act is named after Jeanne Clery, a Lehigh University freshman who was tragically raped and murdered in her campus residence hall in 1986. Clery’s parents believed that had they been aware of the crime occurring on campus, they might have chosen a different school for their daughter. As a result, the Clery Act was passed in 1990 and has since evolved to include additional requirements, such as the rights of sexual assault victims and sex offender notifications.

WHAT ARE CAMPUS SECURITY AUTHORITIES (CSAS)?

Campus Security Authorities (CSAs) are individuals designated to report certain crimes under the Clery Act. CSAs play a critical role in ensuring compliance and maintaining a safe campus environment.

KEY CSA RESPONSIBILITIES

Identify and Report Clery-Reportable Crimes: CSAs must report crimes such as homicide, sexual assault, robbery, aggravated assault, burglary, motor vehicle theft, arson and others outlined under the Clery Act.

Accurate Documentation: Use the provided reporting tools to ensure all crime details are recorded properly.

Prompt Reporting: Timely submission of reports is essential to comply with federal requirements and ensure proper response.

Training: Participate in annual CSA training to stay informed about responsibilities and updates to the Clery Act.

CSA TOOLS AND RESOURCES

Annual Security and Fire Safety Report: 2024 ASR/FSR

Daily Crime Logs: Access Here

Campus Security Authority & Title IX Training

DCSS Clery Crime Definitions

CLERY COMPLIANCE SUPPORT

Thomas L. Quarles, Director and Chief of DCSS
Phone: 615-327-6185
Email: tquarles@mmc.edu

Frank P. Hursak, Assistant Director and Assistant Chief of DCSS
Phone: 615-327-6201
Email: fhursak@mmc.edu