Title IX Incident Report
This form may be completed by any student, vendor, or visitor to report an alleged Title IX incident or by any LMU employee who observes or receives a disclosure of a Title IX allegation. Title IX incidents include, but are not limited to, gender-based discrimination, sexual harassment, non-consensual sexual contact (battery/rape), domestic/intimate partner violence, stalking, and/or bullying. Follow guidance within this form for each section.
  • - -

  • Complainant Information

    (the individual(s) who may identify as the victim):
  • - -

  • Respondent Information

    (the individual(s) who may be identified as the accused):
  • - -

  • Priority

    (Select the risk level you believe mopst likely represents this incident below)
  • Click in the box above to begin typing your statement.
  • Click in the box above to begin typing in paragraph or bullet format any and all actions that have been taken by you or the complainant.. For example: "Contacted Police Officer John Doe for guidance" or "Called LMU Counseling Office to make a referral" or "Sought medical treatment at XYZ facility."
  • Image Verification
    captcha
    Please enter the text from the image:
    [Refresh Image] [What's This?]