Student Life

Title IX Incident Reporting Form

Submit this form to report incidents involving suspected violations of PUC’s Sexual Misconduct Policy, which prohibits discrimination, harassment, retaliation, sexual misconduct, intimate partner violence, and stalking.

All PUC administrators, staff, and faculty, with the exception of those working in a confidential capacity (Career and Counseling Center counselors and staff, Health Services medical providers and staff, and the PUC Chaplain), who learn of suspected instances of discrimination, harassment or sexual misconduct, have a responsibility to report the information immediately to the Title IX Office, Tanya Healy, Title IX Coordinator, thealy@puc.edu, (707) 965-6226.

Filing this report serves as official notice to PUC and authorizes the Title IX coordinator to initiate a preliminary inquiry into the information and allegations contained within this report. Please review PUC’s Sexual Misconduct Policy, for specific rights, including filing reports to law enforcement, reports to OCR, and the right of appeal.

Required fields are marked with an asterisk (*).
Information
Date and time of incident *
If you are a mandated reporter, on what date was the incident reported to you?
Include name, email, phone and other contact information.