Submit A Report or File a Formal Complaint

For additional resources, or if you have questions, contact Leah Reynolds, Ed.D., Title IX Coordinator, at leah.reynolds@lr.edu or TitleIXCoordinator@lr.edu or 828.328.7443.

If you would like to make an anonymous complaint, you may complete this form with all details of the incident except your name and other identifying information. However, if you make an anonymous report, it will limit the university’s ability to respond. If you aren’t sure whether you want to report your name, we encourage you to talk through your options with a confidential resource, including a university counselor, pastor or student health provider.

Today's Date

I am

Filing a report

Filing a formal complaint

Reporter Name

Reporter Email

Reporter Status

Student

Faculty

Staff

Visitor

Contractor

Complaintant(s) First

Complaintant(s) Middle

Complaintant(s) Last

Complaintant(s) Email

Complainant's Status:

Student

Faculty

Staff

Non-LR affiliate

Alleged individual against whom the grievance is asserted ("respondent")

Respondent(s) First

Respondent(s) Middle

Respondent(s) Last

Respondent's Status:

Student

Faculty

Staff

Non-LR affiliate

Respondent's Email

Type of Discrimination

Sexual Harassment - Quid Pro Quo

Sexual Harassment - Hostile Environment

Sexual Assault

Fondling, Rape, Incest, Statutory Rape

Dating Violence

Domestic Violence

Stalking

Incident

Date of Incident

Location of Incident

Explain the incident in full detail

Potential witnesses to the incident

Name and Contact Information (Email)

Documents to Upload:

Unlimited number of files can be uploaded to this field.
256 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Was this reported to law enforcement?

Yes