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Sexual Misconduct and Title IX Reporting Form


Please use this form to report incidents of possible sexual misconduct and/or harassment. You may utilize this form for an incident that you have experienced, witnessed, or have been reported to you.

Completion of this form does not constitute an open investigation and is not considered a formal complaint. Once this form is received, an initial assessment will be conducted to determine further action.   

Please refer to the following for policy details:

Nichols College Title IX Policy

Nichols College Sexual Misconduct Policy

 

There are several confidential resources available to you should you wish to report sexual misconduct, or seek emotional support or medical care. The following resources are completely confidential under most circumstances:

  • Nichols College Health Services: 508-213-2238, counseling@nichols.edu
  • Nichols Counseling Center: 508-213-2108, health.services@nichols.edu
  • Find@Nichols (24/7 Support Line) : 833-434-1217

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As a reminder: all Nichols College faculty members, staff members, and administrators, with the exception of those working in a confidential capacity (e.g., counselors, rape crisis advocates, medical providers) who learn of suspected instances of sexual misconduct, directly or indirectly, have a duty to report the information to the Title IX Coordinator.

Reporting Party Information

If you wish to remain anonymous, please type "Anonymous" in the Name Field. Please note: Depending on the level of information provided about the incident or the individuals involved, the College's ability to respond to an anonymous report may be limited.

 
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Or, you may write Anonymous
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If you wish to remain anonymous, please leave blank
Email address must be of a valid format.
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If you wish to remain anonymous, please leave blank
This field is required.
This field is required.

Witnesses

Please list any individuals who may have information regarding this incident, include as many of the listed fields as you can provide.

Involved party 1

Reporting Party Affiliation

Are you reporting this for an incident that occurred to you personally?(Required)
You must make at least one selection.
Are the individuals listed as witnesses aware that you are submitting an incident form?(Required)
You must make at least one selection.
This field is required.

Supporting Documentation

If you have access to any documents pertaining to the incident (text messages, emails, social media posts, pictures), you may upload them here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission