Incident Report

If this is an emergency, call 911.

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.

TitleIX

Reinhardt ID#
Name
First Last
Phone
Email
Incident Information
Nature of Incident
- Sexual Assault
- Sexual Harrassment
- Gender Discrimination
- Other (description below)
Description from above
Date of Incident
Time of Incident
Did the incident take place on campus or off campus?
- Yes
- No
Where exactly was the location of the incident?
Involved Parties
Victim
First Last
Accused
First Last
Is the accused a member of the Reinhardt community?
- Yes
- No
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.
Was the Police Department of 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.)
Max. file size: 64 MB.
Attachment 2 - Please attach any supporting documentation (pictures, video, emails, texts, etc.)
Max. file size: 64 MB.
Attachment 3 - Please attach any supporting documentation (pictures, video, emails, texts, etc.)
Max. file size: 64 MB.

Incident Report

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TitleIX

Incident Information

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