Proxy Report Form

The form is intended to convey information which will be used to track RIT’s response to an incident being reported where the victim declines to report the incident to law enforcement, Public Safety, or a Title IX coordinator. Please do not promise confidentiality to the reporting person and you can say you will do the very best you can to respect their wishes.

Reporter's Name
Description of pressure or force used against victim
Description of Accused:
Did accused appear to use drugs or alcohol?