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Sexual Misconduct Report Form


Incidents involving sexual harassment, gender bias, stalking, sexual assault, dating violence, and domestic/interpersonal violence are prohibited by the Samford University Sexual Misconduct Policy.

If you witnessed, experienced, or have information about an incident of sexual misconduct, please use this form to report your concern. Reports may also be made directly via email to titleix@samford.edu.

This form is also used to gather information and statistics regarding incidents, and provide resources to aggrieved Samford community members. NOTE: It is not necessary for you to be a victim to complete this form. Victims and aggrieved persons may also use this form to request support.

Completing this form does NOT constitute a police report or a student conduct report. To file an official police report, contact Samford Police at 205-726-2020. To file a student conduct report, please visit https://www.samford.edu/departments/student-conduct/. 

This form provides you with the ability to report information with or without personal identification. All reports of sexual misconduct will be investigated, but anonymous reporting may prevent the university from certain action and/or resolution.  Your report is important to the wellbeing of our community and will be processed with thoughtful and thorough consideration.

Background Information

 
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Student, Staff, or Faculty
Email address must be of a valid format.
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Involved Parties

Please include the names of all known parties involved in or effected by the incident.

Involved party 1

Questions

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If you were not directly involved in the incident, how did you come to know about it?(Required)
You must make at least one selection.
Were involved parties under the influence of drugs or alcohol?(Required)
You must make at least one selection.
Which parties were under the influence of drugs or alcolhol?(Required)
You must make at least one selection.
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If you are open to follow up, how do you prefer to be contacted?(Required)
You must make at least one selection.

Supporting Documentation

Please upload any supporting documentation (screenshots, photos, emails, etc). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission