Title IX Anonymous Report Form
You may submit an anonymous and confidential report of sex discrimination, including sexual harassment or sexual violence, by using this form. Fill in the information requested below, to the best of your ability, and click the blue SUBMIT button when you are finished. This information will be received confidentially by the District’s Title IX Coordinator, Megan Farrell. Her duties include reviewing and coordinating the District’s response to Title IX reports and complaints. She is the responsible employee to handle reports or complaints regarding unlawful discrimination, including sexual harassment and sexual violence. You may contact her via email at complianceofficer@pausd.org or via phone at (650) 833-4248.

Once the Title IX Coordinator receives your anonymous report, she will look into the matter and contact you within 10 days if you have requested to be contacted and if you have provided your contact information in the form below. If you have chosen not to provide your identity or contact information, the Title IX Coordinator will review the information you submitted and determine the available next steps in order to address the matter.

The form below collects information on incidences of sexual assault, sexual harassment, dating/interpersonal relationship violence, or stalking. Anonymous reports are used to gather information about these incidents at PAUSD, and compiled data are used to inform the community about our campus climate. As mentioned above, you may *optionally* provide an email address or telephone number if you would like the Title IX Coordinator to contact you. Your submission will be stored in a password protected system only accessible by the Title IX Coordinator and other District personnel approved by the Title IX Coordinator for any subsequent investigation.

If you would like to speak confidentially to the Title IX Coordinator now, please call 650-833-4262.
Affiliation with the Incident: *
Nature of the allegation (check all that apply):
Have you made any previous reports about this incident to anyone at PAUSD? *
The following questions ask about the incident(s) that you are reporting. If any information is unknown, please leave the question blank.
Date of incident:
MM
/
DD
/
YYYY
Approximate time of incident:
Time
:
Victim/Survivor's gender:
Victim/Survivor's age:
Your answer
School where Victim/Survivor was enrolled:
Your answer
Victim/Survivor's affiliation with PAUSD:
Is there ongoing abuse?
Is drugging of the Victim/Survivor suspected?
Alleged Perpetrator's gender:
Alleged Perpetrator's Age:
Your answer
Alleged Perpetrator's affiliation with PAUSD?
Relationship of Victim/Survivor and alleged Perpetrator: *
Location of incident: *
Did the incident occur at a PAUSD sponsored event or at a school district activity off campus?
[Optional] If you wish, you may provide the name of the alleged perpetrator:
Your answer
Would you like the Title IX Coordinator to contact you? *
[Optional] If you answered yes above, please provide a phone number or email address at which you may be reached.
Your answer
Submit
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