Title IX Report Form

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Please submit any concern(s) or report(s) that you may have for the Title IX Office below. We can also be reached at TIX@cmu.edu.

Please note - this is not an anonymous form. Our office will be in touch with you after receiving your submission to provide information about resources, supportive measures and the option to set up a meeting.

To make a report anonymously, call 844-587-0793 or visit cmu.ethicspoint.com

Email *

Are you reporting a concern on behalf of yourself or someone else?

Self

Someone else

Other:

Clear selection

If you are reporting on behalf of someone else, would they be comfortable with an outreach from our office?

Yes

Maybe

Other:

Clear selection

Name of Impacted Party (self or someone else) and Andrew ID, if applicable

Best Contact Information for Impacted Party

Approximate Date of Concern/Incident

Is this concern ongoing?

Yes

Other:

Clear selection

Which categories apply to your concern(s)? (select all that apply)

Sexual Assault - a physical, sexual act against another person without their consent. This includes a range of acts including unwanted groping, fondling and penetration.

Sexual Harassment - unwelcome conduct or cues of a sexual nature whether verbal/aural (sounds), visual/graphic e.g., pictures and videos), physical, Quid Pro Quo and Hostile Work Environment.

Dating/Domestic Violence - any act or threat of physical or sexual violence made against a dating or sexual partner, spouse or family member.

Stalking - engaging in a pattern of conduct or communications, directed at one person, that causes fear of harm or emotional distress.

Sexual Exploitation - taking sexual advantage of someone without consent, or violating someone’s sexual privacy without consent.

Sex-Based Discrimination - being treated worse in your education or employment on the basis of biological sex; gender identity or expression; and/or sexual orientation.

I'm not sure

Undisclosed

Other:

What additional information would you like to share with the Title IX Office?

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