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Office of Title IX & Equal Opportunity Report It Form


IF THERE IS IMMEDIATE RISK TO LIFE OR PROPERTY, CALL THE UNIVERSITY POLICE DEPARTMENT AT (956) 882-4911 or DIAL 911

 

The University of Texas Rio Grande Valley is committed to maintaining a learning, living and work environment free of sexual misconduct and discrimination based on race, national origin, color, sex, sexual orientation, gender identity, gender expression, religion, age, disability, genetic information, and veteran status.

The University of Texas Rio Grande Valley respects the sensitivity of your report. We keep the information as private as possible, even though it is not confidential.

If completing this form anonymously, please provide specific details about events, given that anonymous reports can greatly limit UTRGV’s ability to stop misconduct, collect evidence, or take effective action against individuals or organizations accused of violating policy. Please consider providing contact information so we can ask follow-up questions. [Note: Some features of this form require a Flash-enabled computer.]

 

Background Information

 
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If you wish to remain anonymous, please leave this section blank
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Please describe your position on campus (IE Student, Employee title, etc.)
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Please provide the best telephone number for us to contact
Email address must be of a valid format.
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Please provide your UTRGV e-mail if possible
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Please provide your office location or your home address
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Please select one of the following options
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If unsure or if this happened multiple times specify in narrative & put today's date
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If unsure or if this happened multiple times specify in narrative & put today's date
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Select a location from the drop down menu
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Building? Room? Address? Where exactly?

Involved Parties (including reporter)

Please list all involved parties (including the reporter)

Involved party 1

Questions

Please answer the following questions as completely as possible

What is your relationship to the University?(Required)
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What type of resolution would you like?(Required)
You must make at least one selection.
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Was law enforcement notified or medical services sought?(Required)
You must make at least one selection.
Would you like the Office for Advocacy & Violence Prevention (OAVP) to contact you? (OAVP provides free, confidential, and victim-centered resources and services to all UTRGV community members.)(Required)
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Please acknowledge the following by clicking on the button(Required)
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Supporting Documentation

Please make sure that all items are clearly labeled and match descriptions given earlier. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission