Sexual or Interpersonal Misconduct Report Form

Escape

This form will provide the Title IX Coordinator with basic information regarding alleged incidents of sexual or interpersonal misconduct. An asterisk (*) indicates a required field. Please fill out all requested information and click 'submit'.

THIS IS NOT A POLICE REPORT.
If this is an emergency, dial 9-1-1 (GMU PD operates 24/7 on all three Virginia campuses).
NOTE: Non-identifying information will be shared with GMU PD if an immediate or ongoing threat to campus is reported.

To provide information regarding alleged incidents of protected class discrimination or ethics violations, please click here to fill out our Intake Form.

Reporter Information

Your Full Name

Your GMU Affiliation

Your Email*

Your Phone Number

Background Information

Please provide us with as much information as possible.

The person who experienced the misconduct is the COMPLAINANT.
The person who is accused of misconduct is the RESPONDENT.

Date of Incident (if known)

Time of Incident (if known)

Location of Incident (if known)

Specific Location (if known)

Complainant Name

Complaint Pronouns

Complaint GMU Affiliation

Complainant Contact Information (GMUID, email, phone)*

Respondent Name (if known)

Respondent Pronouns

Respondent GMU Affiliation

Respondent Contact Information (GMUID, email, phone)*

Complaint

Tell Us What Happened*

Was this incident reported to anyone else? If so, to whom?*

Additional Information*