Sexual Misconduct Incident Report

Please complete this online form to report an incident of sexual misconduct to the University. Alternatively, you may request a printable form by sending an email to titleix@lourdes.edu.

Note: This online report is not 911 or Emergency Service. Please contact Campus Security 419-574-3861 or emergency responders at 911 for an immediate response.

Lourdes University understands that some individuals filing Sexual Misconduct Incident Reports or who are otherwise involved in an incident may want their identity to remain anonymous. The amount of detail provided will largely determine the University’s ability to respond to reports of sexual misconduct. In all cases, issues of confidentiality will be balanced against the University’s commitment to addressing incidents of sexual misconduct and providing a safe campus community.

Your name
Your email address
Your phone number
Your relationship to the University
Type of incident/concern
Please provide as much detail as possible regarding the incident/concern:
Did the incident occur on-campus or off-campus?
Please provide as much detail as possible regarding the location of the incident/concern:
Have you previously reported this incident/concern to a University employee?
Victim:
Name
Relationship to the University (if different from above)
Gender
Respondent (the "accused" party/parties):
Name (if different from above)
Relationship to the University (if different from above)
Gender
Please email any supporting documents, photos, etc. to titleix@lourdes.edu with “SMIR” and the date on which you submitted this form in the subject line of your email. Please allow the University two business days to review and respond to your report.

By clicking the “Submit” button below, you are signing this report electronically and confirming that the information you have provided is accurate and to the best of your knowledge.
Phone
This field is for validation purposes and should be left unchanged.