University of Oregon

Anonymous Sexual Assault Report Form

ANONYMOUS REPORT FORM
SEXUAL HARASSMENT, SEXUAL ASSAULT, PARTNER VIOLENCE & STALKING

NOTE:  University employees, including student staff, must report to their supervisor or the
Office of Affirmative Action & Equal Opportunity if they receive notice of an incident of sexual harassment, including sexual assault, partner violence and stalking.

The university takes sexual harassment, including issues of sexual and interpersonal violence, seriously.  If you as a student survivor or reporter wish to remain anonymous, fill out this Anonymous Report Form. The university will use this information for statistical purposes, to better understand the scope of sexual violence on campus, and to develop and implement preventive efforts. If you fill this form out with a University employee, including a student employee, the report will no longer be anonymous.

The university is required to investigate allegations of sexual misconduct to the best of its ability.  As a result, the university will follow up on any specific, identifying information provided in this anonymous report.

If you wish to discuss a concern while maintaining confidence to the greatest extent possible, you have the following options:

  • Counseling professionals in the University Counseling & Testing Center (541-346-3227) have a limited privilege to protect information shared with them, consistent with state and federal law.
  • Health care professionals in the University Health Center (541-346-2770) have a limited privilege to protect information shared with them, consistent with state and federal law.
  • The off-campus community resource Sexual Assault Support Services (541-343-7277) can provide free confidential support and advocacy, but cannot arrange for campus-based services or accommodations.
 
To submit an anonymous report of sexual misconduct, please fill out the form below to the best of your ability, and submit. Please note that some questions ask you to check all the answers that apply, so you may make more than once selection.

 

Incident Information
:
Survivor Information
Offender Information

NON-ANONYMOUS REPORTING

If you wish for the university to investigate the matter you are reporting, please report the matter to the University of Oregon Police Department (541-346-2919 non-emergencies; 9-1-1 emergencies), the Office of the Dean of Students (541-346-3216), or the Office of Affirmative Action & Equal Opportunity (541-346-3123).  Once you contact these offices or disclose identifiable information to a UO employee, the university will have a duty to investigate based on available information.

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