Online Incident Report Form
This online form can be used by EQUALS students and staff to report an incident of sexual assault or sexual harassment. It may also be used by someone who has witnessed an incident or is a support person for someone who has experienced sexual assault or sexual harassment.
Please note that if you are reporting on behalf of another person, you must have their consent before you do so.
Complaints of sexual assault and sexual harassment are directed to the Campus Coordinator, depending on whether the incident relates to a student, a staff member, or a visitor to our campus.
I am :
A student reporting another EQUALS student
A student reporting an EQUALS staff member
A student reporting someone else
A staff member
A First Responder (recording a disclosure)
Someone who has experienced sexual assault or sexual harassment
A person who has witnessed an incident of sexual assault or sexual harassment
A support person for someone who has experienced sexual assault or sexual harassment
Other (please specify below)
My report relates to the action(s) of:
When did the incident occur?
In the last 24 hours
In the last week
In the last month
In the last year
Over a year ago
Where did the incident occur?
Please use this box for additional information:
What action would you like EQUALS to take?
Contact you confidentially and let you know what options are available as a next step for you
Provide you with details on specific support services available to you
Manage the report in line with EQUALS' policy and procedures
Assist you to make a report to the police
No further action
Other (please provide details)
Your Personal Details
You do not have to reveal your name in order to make a report. However, if you identify yourself and there is a serious risk of harm to you or another person and/or EQUALS is required by law, your identity may have to be disclosed.
This would only happen in exceptional circumstances and EQUALS would try and let you know before that step was taken.
Best contact number:
Preferred method of contact
Please contact me by phone
Please email me
First Responder Only
Please confirm that you have provided the following information to the complainant:
Support options at EQUALS
Reporting options at EQUALS
External support options
External reporting options
Other (provide details below)
Tick to confirm that this is a disclosure only and that the complainant does not wish to make a formal report at this time.
Important note prior to submission.
If you are under the age of 18 and report a sexual assault, EQUALS is legally obliged to report the matter to the Child Abuse Report Line.
Send me a copy of my responses
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