Title IX Incident Report Form
This form is for filing report incidents of discrimination, sexual violence (harassment, assault, misconduct), sex/gender discrimination, and harassment that you believe are in violation of ÏãåúÖ±²¥â€™s policy. This form is to prevent, protect, assess any possible Title IX issues and incidents. When filling out this form understand this does not constitute as filing a Formal Complaint. This report is to reach out to the affected party to ensure safety, give supportive measures, and explain further options.
If this is emergency please call 911.
If you feel unsafe please call Public Safety at 304-904-2041.
Who can fill this out
Anyone can report on someone else’s behalf or for themselves. All faculty, staff, graduate students, are considered mandatory reporters and are encouraged to report. Those who are not mandatory reporters are counselors and H.O.P.E. advocate.
Is this confidential?
No, this is not a confidential form. It will be sent to the Title IX Coordinator so they can reach out to affected party.