Occidental College Logo

Civil Rights & Title IX Office Reporting Form


If you need to report an emergency, do not use this form. Instead, call Campus Safety at (323) 259-2599, or dial 911.

DO NOT USE THIS FORM for reporting a suspected violation of the Code of Student Conduct. Please use the General Incident Reporting Form.

This form is designed to provide students, faculty, staff and administrators with an online method to report specific information related to an alleged incident(s) of discrimination or harassment (including sexual misconduct and sexual violence), dating and domestic violence, stalking, sexual exploitation or retaliation.

Prior to completing this form, please review Occidental College's Sexual and Interpersonal Misconduct Policy and/or the Discrimination, Harassment, and Retaliation (DHR) Policy.

You are not required to complete the entire form in order for the complaint to be submitted. If you do not know the date of the incident (a required field) enter the date for the day you submit the form and indicate in the narrative section that you do not know the date of the incident.

Background Information

 
Enable additional features by logging in.
Email address must be of a valid format.
This field is required.
This field is required.

Involved Parties

Please list yourself and all individuals, including as many of the listed fields as you can provide. For non-students involved in the incident, please list available information. If a Non-Student is involved, please indicate whether they are students at another college/university.

Involved party 1

Description/Narrative

Are you making this report to fulfill your obligations as a responsible employee?(Required)
This field is required.
Reason(s) for Report: Please indicate all relevant category/categories that pertain to this incident report.
You must make at least one selection.
If you selected "discrimination" or "harassment" on the previous question, what protected characteristic is the discrimination or harassment based on?
You must make at least one selection.
This field is required.
Was Campus Safety called?
This field is required.

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