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Sexual Misconduct or Stalking Report Form


Do not use this form to report events presenting an immediate threat to health or safety. If you require emergency assistance, please dial 911.

Use this form to report any possible violations of Florida State University's Sex Discrimination and Sexual Misconduct Policy such as all forms of non-consensual sexual activity and unwelcome sexual conduct including: sex discrimination, sexual violence (rape/sexual battery/sexual assault), sexual harassment, relationship violence (domestic violence and dating violence), stalking, harassment or violence based on sexual orientation, gender identity or gender expression, and other forms of sexually exploitative behavior.

If you are unsure or would like to speak to someone about completing this form, please contact Terri Brown, Title IX Director, at 850-645-2741 or tsbrown@fsu.edu.

Background Information

This report form can be used by parties wishing to file a report on their own behalf, or by University mandatory reporters, or by anyone wishing to file a report on behalf of another.

Reports submitted by University employees must include the employee's name and contact information.

 
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Email address must be of a valid format.
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If the date of the incident is unknown, please indicate the date of the disclosure.
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If the time of the incident is unknown, please indicate the time of the disclosure.
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On campus incidents: room number if known. Off campus incidents: street address if known.

Involved Parties

Please list all involved parties. Complete as many of the listed fields as you are able. "Reporting Student" and "Reporting Party" are the individuals who have disclosed possible sexual misconduct. "Responding Student" and "Responding Party" are the individuals who are being accused of committing possible sexual misconduct.

Involved party 1

Questions

Please identify other departments/community partners that have been notified.(Required)
You must make at least one selection.
If you a Responsible Employee (mandatory reporter), have you notified the Reporting Student that you are filing this report?(Required)
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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.

Submission