Title IX Confidential Reporting Form: STUDENT Sexual Harassment and/or Gender Based Discrimination
You may submit a 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 SFUSD's Office of Equity, the office responsible for handling reports or complaints regarding unlawful discrimination, including sexual harassment and sexual violence. You may contact the Office of Equity confidentially via email or phone: equity@sfusd.edu / (415) 335-7334.

Once the District Title IX Coordinator receives your confidential report, they contact you within 2 school 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 Coordinators will review the information you submitted and determine the available next steps in order to address the matter. The District's Title IX Coordinators will work with the school sites to ensure the District's policies and procedures for responding to sexual harassment and assault complaints are followed.

The form below collects information on incidences of sexual assault, sexual harassment, dating/interpersonal relationship violence, or stalking. Your submission will be stored in a password protected system only accessible by the District Title IX Coordinator and other District personnel approved by the District Title IX Coordinator for any subsequent investigation.

If you wish to report an incident of sexual harassment or discrimination by an SFUSD employee, please contact Human Resources (Talent Management: Greg John, (415) 241-6101 (ext 1230)/johnr@sfusd.edu). If you complete this form regarding conduct of an SFUSD employee, the information will be forwarded to Mr. John.

Definitions and Examples:

●Sexual Harassment: is defined as unwelcome sexual advances, requests for sexual favors, or verbal, visual, or physical conduct of a sexual nature, made by someone from or in the educational setting. (Education Code 48900.2)
○Examples:
•Verbal: Insults, name-calling, and offensive jokes based on sex, and intimidation by words or actions, bullying based on sex
•Visual: Sexual gestures, exposing and/or grabbing own genitalia in front of someone
•Cyber: Online bullying/threats, sharing naked pictures of a student
•Physical: Examples: Butt slap as a dare, unwanted kiss (depending on severity), forced hugging, impeding or blocking movement, sexual touching of a non-sexual body part coupled with a sexual/verbal comment, pantsing. (depending on circumstances)
●Cyber Sexual Harassment/Bullying: Sharing of, or solicitation or incitement to share, a photograph or other visual record by a student to another student or online through social media. (Education Code 48900(c)(A)(iii))
●Sexual Battery: Nonconsensual sexual touching over the clothes of another student with intent to arouse or gratify the sexual desire of the offender. (Education Code 48900(n), 48915(c)(4))
○Examples: Groping/massaging, butt slap, breast grab, grabbing any other sexual organ.
●Sexual Assault: An act involving penetration, in which a person is coerced or physically forced to engage against their will. (Education Code 48900(n), 48915(c)(4))
○Examples: forced oral copulation, forced penetration, and rape.
●Dating/Relationship Violence: A pattern of coercive behavior used by people to control their intimate partners. It often involves a physical assault or a threat of physical assault, but an abusive relationship may involve verbal and/or emotional abuse; sometimes it begins with these types of abuse and evolves into physical abuse. A physical assault is almost always accompanied by one or more abusive tactics.
●Sex/Gender Based Harassment: Unwelcome conduct based on a student’s sex, harassing conduct based on a student’s failure to conform to sex stereotypes

Affiliation with the Incident *
Nature of the Allegation (check all that apply) *
Have you made any previous reports about this incident to anyone at SFUSD? *
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 is/was enrolled or works: *
Your answer
Victim/Survivor's Affiliation with SFUSD
Is there ongoing harassment?
Accused Person's Gender
Accused Person's Age:
Your answer
Accused Person's Affiliation with SFUSD
Relationship of Victim/Survivor to Accused Person: *
Location of incident: *
Did the incident occur at an SFUSD-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 can be reached.
Your answer
[Optional] Description of the Incident:
Your answer
Were there any individuals who witnessed the incident and/or who the victim informed about the incident?
[Optional] If you answered "yes" above, please provide a phone number or email address where the above individual(s) can be reached.
Your answer
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