Sexual Misconduct Reporting Form

IF THIS IS AN EMERGENCY, PLEASE CALL 911 or UH Police AT . THIS FORM MUST NOT TO BE USED TO REPORT INCIDENTS THAT REQUIRE AN IMMEDIATE EMERGENCY RESPONSE.

You can find information regarding the Sexual Misconduct policy at

When should you500彩票下载app二维码 complete this form?

  • Use this form to report attempted or completed incidents of sexual assault, sexual harassment, stalking, dating violence, domestic violence, or sexual exploitation.

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  • Complete this form to the best of you500彩票下载app二维码r ability and the Title IX coordinator or designee will determine how the information will be handled.

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  • Yes you500彩票下载app二维码 may provide information anonymously through this form by leaving you500彩票下载app二维码r contact information blank.
  • Or you500彩票下载app二维码 can report anonymously through
  • Please understand, that anonymous reports limit the university's ability to respond and sharing you500彩票下载app二维码r identity may be helpful to connect you500彩票下载app二维码 with resources, like medical and counseling services, and provide information about you500彩票下载app二维码r options for further action.

What if I am a Responsible Employee reporting an incident I have learned about that involves another person?

  • If you500彩票下载app二维码 are reporting as part of you500彩票下载app二维码r requirement as a responsible employee under Title IX, you500彩票下载app二维码 can identify you500彩票下载app二维码r role in STEP 3 of using this form.

The information provided in this report can be used by the university to conduct an investigation or take actions to stop the behavior and prevent its recurrence. If you500彩票下载app二维码 have other questions contact the by email or by phone .

Step 1: Information on person submitting this form

Step 2: Involved Parties

Step 3: Questions

Are you500彩票下载app二维码 reporting as a Responsible Employee?

Action Requested: By completing and submitting this form I am requesting the following:



Have you500彩票下载app二维码 filed a criminal report with the campus police?
Would you500彩票下载app二维码 like to file a criminal report with campus police?

Step 4: Supporting Documentation/Attachements

Photos, video, email and other supporting documents may by attached below. Each file can not be larger than 15 mb.

Select files...


Step 5: Final review