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UMA Mandatory Reporter Form


The University of Maine at Augusta has legal and moral responsibility to provide appropriate support and assistance to any individual who has or is experiencing dating violence, domestic violence, sexual assault, stalking, sexual harassment or other forms of sex discrimination. The entire University of Maine System policy against sex discrimination, often referred to as "Title IX" covered issues, is available here.

All University of Maine at Augusta employees are Mandatory Reporters with the exception of Confidential Resource Advisors and UMA's licensed, clinical Counselors and their clinical interns.

If a student, visitor, or a faculty/staff member has disclosed to you that they are involved in or have previously been involved in a sex-based discrimination or harassment situation, as a mandatory reporter you must report this information.

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This form should be used to report information pertaining to students or UMS employees who have reported experiencing sex discrimination, such sexual harassment, sexual assault, relationship violence (i.e. dating or domestic violence), stalking, and/or retaliation, or other forms of sex discrimination.

UMA respects the sensitivity of the information that the form requests. Filing this secure incident report notifies authorized University officials: UMS Title IX Coordinator, Elizabeth Lavoie, and Deputy Title IX Coordinator for Students, and/or Amie Parker, Deputy Title IX Coordinator for Employees. Please note that as mandated by Title IX federal laws, the information included in this form is not confidential, but will be kept as private as possible with all efforts made to protect individuals and the greater University community.

For assistance:

Students: please call Associate Dean of Students, Anastasia Lima at 621-3226

Employees and/or guests: please call Senior Director of HR and Institutional Equity, Amie Parker, at 207-592-3618


TO REPORT AN EMERGENCY OR IF YOU ARE REPORTING AN INCIDENT THAT POSES AN IMMINENT RISK, CALL 911/POLICE AND THEN CAMPUS SECURITY OR CENTER DIRECTOR.

General Information

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Email address must be of a valid format.
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Please let us know the relationship to UMA of the person you're reporting.
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Please tell us when the individual disclosed the information to you

Involved Parties

Please provide information regarding the individual who experienced the Title IX situation. If you do not know a field, you may leave it empty.

Involved party 1

Questions

Please indicate the nature of the incident(s) you are reporting.(Required)
You must make at least one selection.
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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