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Incident Reporting Forms

Sexual Violence Reporting Forms

Confidential Reporting Form

Information entered here will be submitted to the Campus Victim Advocate and will not be shared with any other individuals or offices without your permission.

Even if you are not comfortable making an official report, please consider reporting confidentially. The more accurate the University's information and statistics on sexual violence are, the more resources we can provide in the future.

Official Reporting Form

When this form is submitted, the University is required to investigate the reported incident.

    • Information entered here will be submitted to the Title IX Coordinator (Director of Equity & Affirmative Action), Dean of Students, and the Campus Victim Advocate.
    • All appropriate steps will be taken to respect the privacy of the individuals involved, while maintaining the ability of the University to investigate the incident and take appropriate action.
    • University employees (other than confidential employees working in the Student Health Center, Counseling Center, and Campus Victim Advocate) are required by law to report any incidents of sexual violence they witness or learn of, and to provide all relevant information.

 

Who can I report an incident to?

There are several offices on campus committed to helping victims of sexual assault, intimate partner violence, stalking and/or sexual harassment.

 

Confidential Offices

Campus Victim Advocate

(920) 424-3127

Advocates provide you with support and information about the legal, medical, and disciplinary options on campus, at the hospital, when reporting to police, in the court room, and in the community for sexual assault, intimate partner violence, stalking and/or sexual harassment.

Advocacy services are free and confidential, and do not require you to report.

 

Counseling Center

(920) 424-2061

Counselors provide support and caring attention while you make difficult decisions about how to proceed after experiences of sexual assault, intimate partner violence, stalking, and/or sexual harassment. They can help you to restore your sense of safety and personal control through crisis and individual counseling, assessment and documentation for academic accommodations due to the effects of sexual assault, sexual harassment, intimate partner violence, and/or stalking; and referral to other campus or community resources.

 

Student Health Center

(920) 424-2424

Physicians and Nurse Practitioners provide you with caring medical attention after sexual assault or domestic/dating violence including pregnancy and STD screening; medical examination and documentation of any injuries experienced and referral to other campus or community services.

 

 

Official Personnel

University employees are required by law to report any incidents of sexual violence they witness or learn of, and to provide all relevant information.

University Police

(920) 424-1212

Any sexual assault, intimate partner violence, stalking and/or sexual harassment committed on campus property, regardless of whether or not the victim or the perpetrator is a student, staff or faculty, should be reported to the University Police.  Call the University Police if there is any question of where to make a report.

 

Dean of Students

(920) 424-3100

The Dean of Students Office investigates students’ formal and informal complaints of sexual assault, intimate partner violence, stalking and/or sexual harassment.  The Dean of Students staff will ensure that you have the support and assistance you need and outline your options.

 

Equity and Affirmative Action Office

(920) 424-2296

Students or employees who believe that sexual harassment has occurred can go to the Affirmative Action Office, your immediate supervisor, or a Department Chair or College Dean. Students may also make a complaint to the Dean of Students.  The student or employee will be informed of options available and the responsibilities associated with the resolution process.  All formal and informal complaints of sexual harassment filed with any of these offices must be investigated by the Affirmative Action Office.

 

Disclaimer

The information supplied by this website is not to be considered legal or medical advice. The website is strictly for informational purposes only.

by greenc08 — last modified Jul 20, 2016 11:16 AM
CONTACT US

Campus Victim Advocate

Stephanie Kitzerow

Phone: (920) 424-3127
Email: kitzeros@uwosh.edu
Office: Dempsey Hall 148C
Hours:

Monday - Friday

8:30 AM - 4:30 PM

24 Hour Sexual Assault Hotline

(920) 722-8150

24 Hour Domestic Abuse Hotline

(920) 235-5998

Campus Victim Advocate Facebook Page

Please like the UWO Campus Victim Advocate Facebook Page!