Student Life

Title IX Incident Reporting Form

Please submit this form to report incidents involving alleged violations of PUC’s Sexual Misconduct Policy, which prohibits discrimination, harassment, retaliation, sexual misconduct, dating and domestic violence, and stalking against students, employees, and third parties.

All PUC staff and faculty, with the exception of those working in a confidential capacity e.g. counselors, medical providers, athletic trainers (working under a medical professional’s oversight), and pastors who learn of suspected instances of discrimination, harassment or sexual misconduct, have a responsibility to report the information immediately to the Title IX Compliance office, Tanya Healy, coordinator (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 (*).
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.