Sexual Assault Anonymous Report

This form is for individuals who have been affected by incidents of dating violence, domestic violence, stalking, sexual assault, sexual harassment discrimination to report them to the Title IX Office.

Note: this form is not for employees to report disclosures that were shared with them by others. Employees should contact the Title IX Office directly to share those disclosures.

First, please know that:

  1. What happened is not your fault
  2. We want to help you if we can

We encourage you to use this form to share your story and help the University understand the needs of the community. All reports are reviewed by theTitle IX Executive Committee for possible action.

You may choose whether to submit reports anonymously or to include your name and contact information. Regardless of how you choose to submit, all current student victims identified will be sent outreach and advocacy information/resources if possible. Victim’s choices regarding alcohol/drug use at the time of an incident do not affect our treatment of their report. We will not consider conduct charges against a victim or bystander acting in good faith who may have used drugs and/or alcohol at or near the time of their assault/incident.

Please know that individuals are not limited to the University’s processes and can file complaints with outside agencies including the New York State Police or through the Office for Civil Rights .

Victim Information
Incident Information
Incident Location
Follow-Up
Does the victim plan to seek action through Criminal Prosecution, Human Resources or the Office of Student Conduct against the offender(s)?
What resources has this person used thus far? (Check all that apply)
Person Submitting Form (Optional)
Would you like to be contacted by the Title IX Office?
If you would like to be contacted by the Title IX Office, please provide your email address in the above field.