Anonymous Report Form for Sexual Assault and Misconduct

Please don't fill out this input box.

Date of Incident (estimate if unsure)

Location of Incident

Please provide a detailed description of the incident*

Your Name

Your Email

Your Phone Number

Person Harmed

Name

Email

Phone Number

Affiliation with UNT Dallas

If others were harmed, provide details

Person Accused

Name

Email

Phone Number

Relationship to Person Harmed

If others were involved, provide details

If this incident has been reported to another campus department or external agency, please describe below

Form UUID Site Name Submit Report  Clear