Title IX Incident Report

Reinhardt University
Report It

This form allows any student, faculty or staff member to report incidents of sexual assault, gender discrimination, or sexual harrassment within the Reinhardt community (on-campus or off-campus).

Please fill out as much information as possible, you are not required to fill out all boxes.

If this is an emergency, please call 9-1-1 immediately.

Person Submitting Report

Reinhardt ID#

Full name

Cell Phone

Email Address

Incident Information

Nature of Report

Date of Incident

MonthDayYear

Time of Incident

:HourMinutesAM/PM Option

Did the incident take place on campus or off campus?

Where exactly was the location of the incident?

Involved Parties

Victim

First and Last NameContact Phone Number

Accused

First and Last NameContact Phone Number

Is the accused a member of the Reinhardt community?

Description/Narrative of Event

Please provide a detailed description of the incident (who, what, where, when, why, and how). Include names of any people involved, possible witnesses, and any faculty/staff you may have contacted.

Incident Description

Was the Police Department or Reinhardt University Public Safety contacted regarding this incident?

Was anyone transported to the hospital, police department, or anywhere else?

Do you have any supporting documentation regarding the incident?

Attachment 1 - Please attach any supporting documentation (pictures, video, emails, texts, etc)

Upload a File

Attachment 2 - Please attach any supporting documentation (pictures, video, emails, texts, etc)

Upload a File

Attachment 3 - Please attach any supporting documentation (pictures, video, emails, texts, etc)

Upload a File