Samford University

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Relationship Violence Anonymous Reporting Form

If you witnessed or have information about a sexual assault crime, please use this form to provide information related to the crime. The University understands there are individuals who possess information about a crime or who have experienced a crime, but do not want to make a formal report. This form provides you with the ability to report information without providing personally identifiable information about yourself. Please know information provided by this form will be investigated, but anonymous reporting may prevent the University from taking action on the information provided. 


 

What is the type of misconduct you are reporting (select one of the following)? 
Who are the individuals involved (required)?  
Victim's name:
Alleged violator’s name:
Describe the incident which leads you to believe that a sexual misconduct or relationship violence occurred?
When and where did the alleged incident happen?
Describe how you came to know about this incident?
Provide the names of all individuals who were involved or who may be contacted about this incident.
To your knowledge: Was either party under the influence of alcohol during this incident?
If so who was under the influence?
To your knowledge: Does the victim wish to be contacted?
Optional:  
What is your name?
How can we contact you?

 

 

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