Report Violations | Tobacco Free

To report a violation of UK’s Tobacco-free Policy please fill out this form or send the information to: ReportTFviolation@uky.edu.
Compliance is everyone’s business.

Date violator(s) observed:

Month

Day

Year

Location violator(s) observed: *

Be as specific as possible

Time violator(s) observed:

Hour

:

Minute

am

pm

Number of violators observed at the location:

Description of violator(s):

Give as much information as possible, e.g., male or female, clothing, glasses, hair color and style, facial hair, student, staff, visitor, vendor

Did you approach the violator(s) and remind of the tobacco-free policy?:

Yes

No

If yes, did the violator(s) comply with the tobacco-free policy?:

Yes

No

Are you a trained TFTA! Volunteer?

Yes

No

Your email address (optional):

Please enter your email address if you are a TFTA! volunteer or if you would like to receive a follow-up response from our TFTA! Ambassadors (optional). All submissions will be kept confidential.

Additional comments: