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Report a Title IX Concern
DPS does not tolerate harassment or discrimination based on protected class, including conduct prohibited by Title IX of the Education Amendments. Please review Board Policy AC and Superintendent Regulation AC-R3 for further details.

Use this form to report a Concern about conduct that might require the initiation of our Title IX response process. Please provide as much detail as you can because we will rely on the information provided here to fully address the Concern you are reporting.

The next step in the Title IX response process is for a Title IX Coordinator to talk with the Complainant identified in this form to offer Supportive Measures and discuss the option to file a formal Complaint.
First and last name of the person completing this form:
First and last name of the Complainant (the person believed to have EXPERIENCED the harassment or discrimination):
How would you describe the Complainant?
Clear selection
If the Complainant is a student or employee, where do they attend school or work?
Please provide contact information for the Complainant, if you have it:
First and last name of the Respondent (the person believed to have perpetrated the harassment or discrimination):
How would you describe the Respondent?
Clear selection
If the Respondent is a student or employee, where do they attend school or work?
Date(s) that the incident(s) took place:
Location where the incident(s) took place:
Does the alleged conduct to the Complainant's protected class? If so, check the applicable box(es) below:
Please provide a description of the conduct giving rise to this Report in as much detail as possible:
Have you already reported this concern to a DPS employee?
Clear selection
If yes, please note the name(s) of the person(s) to whom you reported your concern and what follow up took place:
How may we reach you?
Clear selection
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