Office of Institutional Equity

Background Information

You may submit this form anonymously, though we will be unable to contact you for follow up and response will be limited. You can anonymously communicate with our office about the report using anonymous reporting line.

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Your full name:

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Your name is required if you are fulfilling a duty to report.

Your phone number:

Your email address:

Nature of this report(Required):

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If multiple apply, choose one and list any others in the description portion below.

Sexual Misconduct(Required):

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If you are reporting sexual misconduct, please select the appropriate category from the following:

Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Describe specific location details below

Specific location:

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Add more specific information on the location. If you selected unknown, please share why:

Involved Parties

To file a report or fulfill a duty to report, please enter all known details about involved parties, including full names of the victim/complainant, accused/respondent, and witnesses.

Name or Organization

Select Role

Student or employee ID number (if known)

DOB (YYYY-MM-DD) (if known)

Phone number (if known)

Email address (if known)

Questions

Please provide a description of the incident. If you have a duty to report, please include all details that were disclosed.(Required) This field is required.

Please enter any applicable law enforcement, Children’s Services, or other agency report number here: This field is required.

OIE strives to uphold your privacy. It is important to note that to comply with federal, state, and local laws, as well as Ohio State policies, some information may be required to be shared with appropriate staff members, law enforcement, or other agencies.(Required)

I acknowledge that information in this report may be shared by Ohio State as described above.

You must make at least one selection.

Supporting Documentation

Attach photos, video, email, and other supporting documents below. Do not submit images of minors. Maximum 12 megabytes per file. 1GB maximum total size. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission