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, non-consensual sexual contact, dating violence, and stalking). The information will be used to identify and address troubling trends. Information shared in this form alone will not initiate the formal complaint process or result in anyone going through the grievance process.

In compliance with the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act (Clery Act) (20 U.S.C. section 1092), information submitted via this form reflecting a reportable crime, as defined by the Clery Act, will be included in the Campus Safety Daily Crime Log. No names are included in the Daily Crime Log.

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 speak to someone confidentially on campus about your experience, please contact one of the resources below:
• 24/7 Hotline (323) 341-4141
• Survivor Advocate Karla Aguilar; kaguilar@oxy.edu or (323) 259-1359
• Emmons Counseling: call 323-259-2657 to make an appointment
• Office for Religious & Spiritual Life: 323-259-2621

If you want to confidentially speak with someone off campus, you can contact:

National Rape Crisis Center Hotline: (800) 656-HOPE

Santa Monica Rape Treatment Center
310-319-4000
24-hour emergency medical care and forensic services

Rape, Abuse and Incest National Network (RAINN)
1-800-656-4673
A confidential, anonymous national sexual assault hotline

LA Rape and Battering Hotline (Peace Over Violence)
213-626-3393
A confidential 24-hour crisis line

If you would like to learn about your reporting options and additional support resources available to you, please contact:

Ruth Jones
Title IX Coordinator
323-259-1338
ruthjones@oxy.edu

To review the Occidental College Sexual Misconduct Policy: http://www.oxy.edu/sexual-respect-title-ix/policies-procedures

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    Survivor Information

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    Perpetrator Information

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    Person Reporting Information

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