Menu Toggle Search

Title IX Report Form

Submit a Report

If you or someone you know has been the victim/survivor of discrimination or harassment at Quincy University, you can report it. This form is one of several ways to report interpersonal violence (sexual misconduct, sexual harassment, stalking, dating/domestic violence, retaliation) that involves a member of the University community. Please know that a report initiates a University response to contact the complainant/victim/survivor to discuss supportive measures and appropriate institutional response, including informal and investigative resolution processes as detailed in university policy. If there is an immediate risk to health or safety, call 911 for medical assistance and law enforcement.

Helpful Definitions

  • Complainant: an individual who is alleged to have experienced conduct that could constitute sexual harassment, sexual misconduct or interpersonal violence, as defined by the Federal Title IX regulations or other university policies.
  • Respondent: an individual alleged to have committed conduct that could constitute sexual misconduct and interpersonal violence, including sexual assault, dating/domestic violence, and stalking, as defined by the Federal Title IX regulations, or in other university policies.
Your Name
Date of Incident(Required)
Time of Incident
:
Complainant Affiliation(Required)
Complainant is an individual who is alleged to have experienced conduct that could constitute sexual harassment, sexual misconduct or interpersonal violence, as defined by the Federal Title IX regulations or other university policies.
examples: professor, staff, friend, roommate or I am the complainant
Nature of the Incident or Concern
Please indicate the nature of the incident or concern you are reporting (check all that apply):
Respondent Affiliation(Required)
Respondent is an individual alleged to have committed conduct that could constitute sexual misconduct and interpersonal violence, including sexual assault, dating/domestic violence, and stalking, as defined by the Federal Title IX regulations, or in other university policies.
Please list the name(s) of the person/people involved in the concern/incident. Provide additional details if available. Note: QU employees are mandatory reporters and must report all known information.
Provide a detailed description of the concern or incident using specific, concise language (who, what, where, when, why, and how). Please note, if you are completing this section as the complainant, please provide any information about the incident that you are comfortable sharing. A staff member will be following up with you to discuss resources and next steps. Any additional information that is needed can be provided at that time.
Photos, video, email, and other supporting documents may be attached to your report. Attachments require time to upload, so please be patient after submitting this form.
Max. file size: 256 MB.