Sexual Misconduct Report

Reporter Information

Please know that the inclusion of your personal information is completely voluntary. If you wish to remain anonymous, do not complete those fields. If reporting anonymously be sure to include as much specific detail as possible below.

Your full name (optional):

Student ID Number (optional):

Your phone number (optional):

Your email address (optional):

Email address must be of a valid format.

Your physical address:

Involved Parties

Please include any information about the involved parties to this incident. (optional)

Name or Organization

Role of the party

ID Number

Hall/Address

Questions

University Follow Up: Please indicate if you would like a member of the University administration to follow up with you directly regarding this incident.(Required)

Yes, please contact me. (Please make sure that you have provided some form of contact information above) No

You must make at least one selection.

If you would like the University to follow up with you, please indicate which form of contact you prefer (Phone, Email etc) This field is required.

When: What year did this happen? This field is required.

What season was it?

Spring Summer Fall Winter

You must make at least one selection.

NOTE: If less than 5 days have passed, you may be able to get a forensic exam (also known as a rape kit) to collect potential physical evidence. You may find a list of resources near campus by reviewing the “You Are Not Alone” document linked here. This field is required.

What time of day was it?

Morning Afternoon Evening Late Night (after 10 pm) I know the exact time.

You must make at least one selection.

If you checked, "I know the exact time," please provide the time: This field is required.

Is there anything else you remember about the date? (Examples: holidays, day of the week, games, school or social events around that time, etc.) This field is required.

Where: Where did it happen? This field is required.

Specific location: This field is required.

Are there any other details you remember about the location? (Examples: Exact address, area of campus, intersection, building number, neighborhood, buildings or trees nearby, colors you remember, etc.) This field is required.

People who know, or might know: As the University investigates this incident, they may reach out to anyone described below. Please only include names of people who you’d feel comfortable with the University contacting. Did anyone else see or hear either all or any part of what happened? This field is required.

Did you interact with anyone right before or after the incident? (This could be people who were at the scene of the incident or nearby, who saw you or the perpetrator leave, or who helped you call for help.) This field is required.

What information do you know about any of the people described above? (Examples: how many people, what they saw or heard, their relationship to you, where they may have been standing or sitting, how physically close to you they were) This field is required.

Did you tell anyone about the incident? This field is required.

What information do you know about the people you told? (Who you told, what you told them, when you told them, how you told them (on the phone, in person, over text, etc.) their relationship to you or the perpetrator, etc.) This field is required.

Do you know if the perpetrator told anyone about the incident? This field is required.

Other: This field is required.

We are sorry this has happened and want to make this process as comfortable as possible. Take a moment if you need it or skip this part. Sometimes it is helpful to wait at least 48 hours after an incident to allow time for your thoughts and all the details to come together. What happened? Include anything you can remember around what you felt, saw, heard, smelled, tasted, or anything you can’t forget about your experience or experiences with the perpetrator(s). This field is required.

Perpetrator(s) Information: How many perpetrators were there? (It’s okay if you are not sure, just put what you can remember.) This field is required.

What is their name/What are their names? (If known) This field is required.

Do you know any other information about the perpetrator(s)? (Examples: cell phone number, what job they have, if you’ve seen them before, how you know them, any physical characteristics – hair color, identifiable marks, tattoos, clothing, moles or birthmarks- or anything you could not forget about them) This field is required.

Was the perpetrator with anyone else either at the time of the incident, or directly before or after? This field is required.

What Information do you know about these people? This field is required.

Additional Information: Do you have any additional information or evidence you’d like to share? This field is required.

Electronic Evidence Includes: Emails, Photos, Videos Text Messages Screenshots Social media interactions (Twitter, Instagram, Facebook, Snapchat, etc) Preserving Electronic Evidence: Save copies of electronic evidence, including screenshots of any relevant electronic communication or interaction Don’t delete any messages, even if you have a screenshot Take screenshots in a way that they show the flow of the conversation (repeating the last line on the top of the next screen shot) Physical Evidence includes: Clothing Bedsheets Condoms Any evidence collected as part of a forensic exam (“rape kit”) Photos of injuries Place each item of potential physical evidence in its own paper bag (plastic bags can eliminate DNA) and store someplace only you can access) What types of evidence do you have now (or think might exist)? This field is required.

Supporting Documentation

Please attach any supporting documentation (photos, videos, screenshots, etc.) related to this incident. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Reporter Information

Involved Parties

Questions

Supporting Documentation

Submission