OERC Protected Class Discrimination and Sexual Misconduct Reporting Form

OERC Protected Class Discrimination and Sexual Misconduct Reporting Form [1]

Report an Incident

To report a possible violation of the University of Colorado Protected Class Nondiscrimination Policy (APS 5065 [2]) or the Sexual Misconduct, Intimate Partner Violence, and Stalking Policy (APS 5014 [3]) on behalf of yourself or someone else, you may use the form below or email CUSystemReport@cu.edu [4] directly.

Note: For reports of sexual misconduct, please note that submitting this form does not constitute a formal complaint to the OERC. If you provide contact information, a member of the OERC staff may contact you for additional information to discuss how to file a formal complaint, the formal grievance process, and safety measures.

Your full name:

Your position/title:

Your phone number:

Your email address:

I am reporting something that happened to: *

Someone else

If you are making this report as a responsible employee, is the reporting party aware that you’re making this report?

Yes

Date of incident: *

Month

Day

Year

Location of incident: *

Detailed description of incident: *

Provide a detailed description of the incident(s) including who, what, where, when, why, and how, as known.

How can the OERC assist in identifying potential next steps? *

Support accessing university programs and activities

A meeting to discuss potential complaint resolution option

Documentation of the incident(s)

Unsure or something else

Additional comments or requests

Supporting documentation

Attach any photos, videos, emails, etc., here. Note that files take time to upload, so please be patient after submitting this form.
Files must be less than 2 MB.
Allowed file types: jpg jpeg pdf doc docx xls xlsx mov mp3 zip.

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