Sexual Misconduct, Abuse & Inappropriate Behavior Report Form
The information provided on this form will assist in the investigation of a complaint of sexual misconduct and/or inappropriate behavior. These situations may, but not limited to, the following:
- Between an adult and minor
- Between minors
- Between adults
What is sexual misconduct?
Sexual misconduct includes: rape, sexual assault, sexual coercion, sexual harassment, domestic and dating violence, stalking, and all other forms of sexual violence.
What is abuse?
Abuse is “a pattern of behavior used by one person to gain and maintain power and control over another.” It can involve physical harm, verbal intimidation, emotional, or psychological trauma.
If the incident involves a case of known or suspected abuse or sexual misconduct, the law requires the incident be reported to the county human services department or local law enforcement in the county where the suspected, or known, abuse took place and/or where the victim resides.
The law protects all reporters who make a report "in good faith" for any breach of confidentiality or from legal liability.
What is inappropriate Behavior?
Inappropriate behavior includes sexual misconduct as well as conduct, including verbal, physical, or written conduct, or intentional electronic communication(s) that creates a hostile educational environment by substantially interfering with a student’s educational benefits, opportunities, or performances, or with a student’s physical or psychological well-being.
This form may be used to report an incident or to file a formal complaint
First and Last Name of Person Reporting Incident:
Role of Person Reporting Incident
Student (Witness / Bystander)
Parent / Guardian
Team Coach or Volunteer
Name of Victim
Name (First & Last)
Alleged Offender(s) Information
Name (First & Last) | Age (if known) | School (if known) | Is the offender a student?
On what date(s) did the incident(s) occur?
List all dates of incidents
Where did the incident(s) occur?
List the location(s) of all incidents
Please describe the nature of the incident.
What did the offender(s) say or do?
Has this been reported to the Human Services Department or Sheriff in the county where it occurred or where the victim resides?
Is there any additional information that you would like to provide?
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