Report an Incident

This form is to be used to report sexual harassment, attempted or completed sexual violence, stalking, intimate partner or dating violence, or discrimination based on sex in a university program or activity.  If you or someone you know has been the victim of any of these, you are encouraged to bring it to the attention of the Title IX Coordinator and/or other university official. If you would like to initiate an OSU Police investigation of a sexual assault or other crime, call 9-1-1 if it is an emergency or the OSU Police at (614)292-2121 as soon as possible.

The Title IX Coordinator is available to answer your questions about your options, processes and resources, ensure an appropriate investigation is made as well as to provide guidance and referrals. The Title IX Coordinator may contact you in response to your submission of the report.

Please fill out as much information as possible based on your knowledge of the situation. You may submit an anonymous report; however, without the contact information of the complainant and the ability to investigate further, the university may be limited in how it can respond.

The following terms are used below:
Complainant: The person who submits the report. The complainant may be the victim, a witness or another person who knows about an incident or situation.
Victim/Survivor: The person who experienced the violation or harm.
Respondent: The person accused of perpetrating the violation or harm. If there are more than 2 respondents, please note that in the description of events.
Witness: a person who saw or heard an incident occur or who has relevant information about it.

Kellie Brennan 
Title IX Coordinator
21 E. 11th Ave., Columbus OH 43201
(614) 247-5838 | brennan.241@osu.edu

Deputy Coordinators

For students:
Deirdre Rosenfeld
Associate Director of Student Conduct
(614) 292-0748 | rosenfeld.36@osu.edu

For faculty/staff:
Kristi Hoge
Lead Employee and Labor Relations Consultant 
(614) 292-0854 | hoge.42@osu.edu

For athletics:
Janine Oman
Associate Athletic Director 
(614) 247-7678 | oman.7@osu.edu  

Complainant Information

Victim/Survivor Information

[If different from above]

Respondent #1 Information

[If known, please provide information below]

Respondent #2 Information

[If known, please provide information below]

Incident Information

OSU Police
Other police agency
Student Conduct
Human Resources
Housing Staff
Hospital Staff
Supervisor
Student Health Center
Sexual Violence Education or Support Program
Faculty Member or Academic Advisor

Certification

I hereby certify that the information I have provided is true and correct to the best of my knowledge.