INCIDENT REPORT - SEXUAL MISCONDUCT

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Tufts-Skidmore Spain recognizes and understands that some individuals may want their identity to remain anonymous. In all cases, issues of privacy must be balanced against the program's need to thoroughly investigate and to take appropriatte action.
THIS IS NOT A 112 OR EMERGENCY SERVICE
CONTACT THE POLICE (112) IF YOU NEED IMMEDIATE RESPONSE
THE PROGRAM'S EMERGENCY NUMBER IS 684 03 20 60

INCIDENT DETAILS

Type of concern

Select the type of incident/concern that best represents this situation.

Harassment

Relationship violence

Sexual assault

Sexual exploitation

Stalking

Catcalling

Other:

Clear selection

Description

Provide as much detail as possible regarding this incident/concern.(WHO, WHAT, WHERE, and WHEN, if known)

Previously reported

Have you previously reported this incident to a Tufts-Skidmore Spain employee?

Yes

Clear selection

INCIDENT LOCATION

Where did this incident occur?

IDENTIFICATION AND CONTACT INFORMATION

Do you wish to provide your name and contact information?

Please note that by choosing not to identify yourself; it may limit the program's ability to address this matter.

Yes

Clear selection

Name and contact information (if desired)

Participants

Including but not limited to the responsible parties, victims, witnesses, and/or others.

ACKNOWLEDGEMENT

I acknowledge that the information I provided in this report is accurate and truthful to the best of my knowledge and I will not engage in retaliation of any kind.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Tufts-Skidmore Spain.

Does this form look suspicious? Report

Forms