Sexual Violence Anonymous Reporting Form

This form should be used by members of the Occidental College community who have experienced or have been witness to sexual violence (sexual assault, rape or sexual battery). Information given in this form will be used for Clery Act information only and will be kept confidential. If you are a survivor of sexual violence, there is HELP AVAILABLE: FOR MEDICAL AND PSYCHOLOGICAL HELP The Rape Treatment Center - Santa Monica - UCLA Medical Center is a free resource providing many excellent services. The Rape Treatment Center 1225 Fifteenth Street Santa Monica, CA 90404 (310)-319-4000 dial option 0 If you would like to seek support of a student advocate or need help finding resources on or off campus: Project SAFE (323)-341-4750 If you want to confidentially talk to someone on campus contact: Emmons Health Center at (323)-259-2657, or, The Office for Religious & Spiritual Life at (323)-259-2621 If you want to confidentially talk to someone off campus contact: National Rape Crisis Center Hotline (800) 656-HOPE If you would like to pursue conduct action contact: The Dean of Students Office at (323)-259-2969 To review the Sexual-Misconduct Policy

Survivor Information

Perpetrator Information

Person Reporting Information

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