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Sexual Misconduct Report Form


This form is intended to help the University respond to sexual misconduct incident(s) and assess the danger the incident represents to the community at large. All efforts are made to maintain confidentiality.

If you are unable for any reason to complete this form or would like to submit it using a different method, contact the Title IX Coordinator at 706.867.4560 or TitleIX@ung.edu.

If there is an immediate threat or perceived ongoing threat, immediately call UNG Police (706.864.1500), the local police, or 911.

 

You may report anonymously. If you do, please know we may be limited in our ability to respond to the report. Also, due to federal privacy laws protecting students and employees, you may not be aware of action taken in response to your report.

Background Information

The Complainant (Victim) will be contacted by the Title IX Coordinator or other University official and asked if they want the report to be for informational purposes only or if they want the University to take administrative action.

The Complainant can also pursue a criminal process.

 
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Community, faculty, staff, student (with ID)
Email address must be of a valid format.
This field is required.
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Should you not know the specific date or the incident occurred over multiple dates, use 1-1-1900.
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Leave blank if unknown or occurred over multiple incidents
This field is required.

Involved Parties

Please add the name of all involved parties

Involved party 1

Questions

 

Which of the following represents the reported behavior? You may select more than one.(Required)
You must make at least one selection.
This field is required.
Describe nature of the Respondent's (Alleged Perpetrator) relationship to the Complainant (Victim) prior to incident. Select the one with the best fit.(Required)
This field is required.
Indicate, if any, contact points or departments to which the Complainant (Victim) has reported this incident:(Required)
You must make at least one selection.
This field is required.

Supporting Documentation

Note: If uploading photos, please use .JPG, .JPEG, or .PNG file format. (Some iPhone users will need to select "Most Compatible" in the camera settings. For more information, please see Apple Support.
5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission