Use this form to submit a tobacco use report.

If you have a photo of the violation, please email it to

Date of observance: *
Approximate Time: *
Location: *
Description: *

The following questions are optional

What is your affiliation with Emory?
How would you classify the affiliation of the person(s) you observed using tobacco? Choose all that apply.
Was there a Tobacco Free sign nearby?
Do you have any suggestions for Emory's Tobacco Free Task Force?