Sexual Misconduct Report Form
Form to Report Sexual Harassment, Sexual Assault, Dating Violence, Domestic Violence, Stalking, or Sexual Exploitation.
The University of Rochester is committed to providing a safe environment to work, learn, live, and socialize together without fear of sexual assault, harassment, or discrimination. Students, faculty, staff, visitors, and others can utilize the sexual misconduct report form – anonymously if preferred – to provide information about conduct or prohibited behavior(s) they have witnessed or experienced that violates University policies.
If you need immediate help
- Call University Public Safety: (585) 275-3333
- Dial #13 on campus blue light phones
- Call 911
Review the below information prior to submitting your online report form.
The University of Rochester’s Title IX Coordinator reviews all submitted reports and retains the information in the Title IX Office. Please note that reports submitted using this form will be reviewed during University business hours and operations.
If the Affected Party/Complainant provides their name and contact information, a staff member from the Title IX Office will reach out to that individual and provide resources, support, and information on options and next steps. A report of conduct prohibited by Title IX is not the same as a formal complaint. A report, independently, does not automatically trigger a grievance procedure or investigation.
All employees, staff, and faculty of the University who do not serve in a Confidential Employee role (as defined in the University Title IX Policy), are Mandatory Reporters and are required to include their name and contact information in this form, and the name(s) of the disclosing individual, the name of the accused party (if shared), and other involved individuals.
Please note that Title IX Coordinators and Deputy Title IX Coordinators are private, but not confidential resources. They will address your submitted report with sensitivity and keep your information as private as possible.
If you wish to remain anonymous, you may enter “anonymous” in the name field. While the University takes all reports seriously, our ability to take action on anonymous reports, depending on the information that is shared, will likely be limited and may be impossible.
In cases of anonymous reports for which we are unable to take action, the University will use the information shared for statistical purposes, to better understand the scope of sexual misconduct on campus, and to develop and implement preventive efforts.
Please visit the pages below for additional information about:
Instructions
Please fill out the form below to the best of your ability. As indicated, you may select all options that apply to your situation for certain questions. You are not required to complete the entire form to submit. If you wish to remain anonymous, you may leave information fields blank.
If you have trouble accessing or using this form, please contact (585) 275-7814. You may also report the issue using the University’s contact form.