Sexual Misconduct/Discrimination or Harassment Based on Protected Class Incident Reporting Form

Background Information

Completed reports will be reviewed by the Office of AA/EEO and/or the Title IX Coordinator during normal business hours (Monday-Friday 7:45 a.m. – 4:45 p.m.) Appropriate follow-up steps will be implemented by our staff members. This may include contacting you to gather additional information and/or providing support and resources to you. Please note that anonymously submitted forms may limit our effectiveness in responding to suspected violations of Auburn University’s policies.

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Nature of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Time of incident:

Location of incident(Required):

This field is required.

Specific location:

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Ex. Room 3231

Involved Parties

When considering the roles of individuals involved, please use the following definitions as a guide:

Respondent: The individual who may have violated university policy.
Complainant: A person who has been impacted by the alleged behaviors of the Respondent.
Witness: Someone who can provide information about the incident or may have been indirectly impacted by misconduct. A witness is not alleged to have engaged in a potential policy violation or behavior that has impacted another person.

Name or Organization

Select Gender

Select Role

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Detailed Description of Incident

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Detailed Description of Incident

Supporting Documentation

Submission