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Title IX Sex Discrimination, Sexual Harassment, and Sexual Violence


This form should be used to report an incident involving an alleged violation of the University of Alabama at Birmingham Title IX Sex Discrimination, Sexual Harassment, and Sexual Violence Policy (including gender-based assault, harassment, exploitation, dating and domestic violence, stalking, as well as discrimination based on sex, sexual orientation, gender identity, and gender expression, and related retaliation). This report form can be utilized by someone wishing to file a report on their own behalf or by anyone wishing to file a report on behalf of a member of the University community.

Please note that submissions using this form may not be reviewed outside of normal business hours.If there is immediate risk to health or safety, please contact UAB Police & Public Safety Department at 205-934-3535 or 911.

Background Information

Email address must be of a valid format.
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Involved Parties/Witnesses

Please list the individuals involved (excluding yourself), include as many of the listed fields as you can provide.

Involved party 1

Narrative Information/Notifications

Please complete the fields below.

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Please indicate other departments that have been notified (optional):
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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