Confidential Report (Blind Report) Incident of Sexual Assault


Warning message

Confidential or sensitive data, or data that is personally identifiable should never be collected or stored on publicly available websites. See supporting documentation for University Policy 311 - Guideline for Data Handling.

Note: Even though the reporter is not identified in this form, Police & Public Safety will use the information provided to investigate the reported conduct to the extent possible.

Directions: The person filling out this form will either print the completed form, place it in an addressed (UNC Charlotte PPS Sgt. Sarah Smyre) sealed envelope, and place it in the University Mail Service or send the form electronically via the email link on the UNC Charlotte PPS Clery Blind Report form page.

SPECIAL NOTE: CSAs are required to provide a hardcopy of the CSA Resource Guide to all victims.  (This requirement is mandated by the Department of Education.)

CSA Resource Guide