If this is an emergency or if you are in immediate danger, call 911.

Please allow up to 48 hours for a member of our team to contact you. Your safety and well-being are our priority, and we will respond as soon as possible.

Notice on Privacy and Information Sharing

This form is not confidential. The information you provide may be shared with others for the purpose of advocating on your behalf and/or clarifying details related to your concern. When information is shared, it is only with relevant advocacy organizations or campus departments, such as the Center for Civil Rights and Equal Access or Student Conduct. By submitting this form, you acknowledge and understand this.