ANONYMOUS REPORT FORM: Sexual violence, Sexual Assault, Rape, Sexual Harassment Domestic Violence, Dating Violence, Stalking
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NOTE: Doane University employees, including student staff, may be required to report to the Title IX Coordinator (email@example.com) or the Public Safety Office (firstname.lastname@example.org) if they receive notice of an incident of Sexual Violence, Sexual Assault, Rape, Sexual Harassment, Domestic Violence, Dating Violence, or Stalking. Employees, including student staff, are only required to report if you are identified as a “Responsible Employee”. Please see the full policy to determine which type of responsibility you have. Doane University takes all forms of sexual violence and harassment seriously. If you as a student or employee survivor or reporter wish to remain anonymous, fill out this Anonymous Report Form. Doane University will use this information for statistical purposes, to better understand the scope of sexual violence on campus, and to develop and implement preventive efforts. If you fill this form out with a Doane University employee, including a student employee, the report will no longer be anonymous.
Doane University is required to investigate allegations of sexual misconduct to the best of its ability. As a result, Doane University will follow up on any specific, identifying information provided in this anonymous report. If you wish to discuss a concern, while maintaining confidence to the greatest extent possible, you have the following options:
Health and Wellness Director – Kelly Jirovec (Kelly.email@example.com)
To submit an anonymous report of sexual violence please fill out the form below to the best of your ability, and submit. Please note that some questions ask you to check all the answers that apply, so you may make more than once selection.
- Complainant: an individual who is alleged to be the victim of conduct that could constitute sexual violence, sexual assault, rape, sexual harassment, domestic violence, dating violence or stalking.
- Respondent: an individual who has been reported to be the perpetrator of conduct that could constitute sexual violence, sexual assault, rape, sexual harassment, domestic violence, dating violence or stalking.