Report an Incident

Please use this form to report incidents of discrimination, sexual misconduct or any other Title IX violation you have experienced, witnessed, have knowledge of or that has been reported to you. Completion of this form does not constitute an open investigation. Once this form is completed and has been received, an initial assessment will be conducted and the Complainant will be contacted to to discuss support services, the grievance process and other options.

If you need immediate assistance, contact the University Police Department at 936-294-1000 or call 911. Reports will be reviewed during business hours, Monday – Friday 8am to 5pm.

I am a*

Student

Employee

Other

Do you wish to remain anonymous?*

Yes

What is your role in the incident?*

Mandatory Reporter

Complainant

Witness

Other

Your Full Name*

Your Email*

Your Phone Number*

Your Phone Extension*

Primary Complainant Name*

Primary Complainant Sam ID

Primary Complainant Email

Primary Complainant Phone Number

Primary Respondent Name

Primary Respondent Email

Primary Respondent Phone Number

Primary Respondent Description

Identify Complainant(s)*

Provide as much detail as possible for each person that the action(s) were directed towards. Details may include names, phone numbers, or physical characteristics.

Identify Respondent(s)*

Provide as much detail as possible for each person that performed the actions. Details may include names, phone numbers, or physical characteristics.

Identify Additional Parties (if any)

Provide the name, phone number (if known) and any other identifying details for any person involved.

Date of Incident

Location(s) of Incident*

Please be as specific as possible; if unknown, indicate unknown.

Describe the Incident*

Please provide a detailed description of the alleged incident (who, what, when and where)

Upload Supporting Evidence

Supporting evidence includes: videos, screenshots, emails, photos, text messages or other evidence to support allegations.

Select file