Sexualized Violence Prevention and Response

Please use this form if you have experienced an incident of sexualized violence AND you wish to submit a formal report to College of the Rockies.

Option 1
Formal Process

Completing and submitting this form initiates a formal process under College of the Rockies’ 4.8.8 Sexualized Violence Prevention & Response policy.


Option 2
Informal Process

If you do not wish to initiate a formal process or you haven’t decided, you may reach out to the College of the Rockies contacts listed below in Next Steps to learn more about your options, including how to access supports, services or accommodations.

Before Filling-Out This Form

The fields on this form are NOT mandatory. However… please be aware that if you do not provide a method for us to contact you (at question 4), College of the Rockies’ ability to respond and/or take further action will be limited.

After Submitting This Form

The form will be received and reviewed within 72 hours by:

Director of Student Affairs or designate (for matters involving students)
Human Resources Advisor or designate (for matters involving employees)

Next Steps

You will be contacted directly by one of these offices to confirm the form’s information and to confirm the next steps.

Student Contact:
Director of Student Affairs or designate
Confidential Phone: 250-489-2751 x4999

Employee Contact:
Human Resources Advisor or designate
Confidential Phone: 250-489-2751 x4999

Your Info

● The information provided on this form is administered and retained in accordance with College of the Rockies Sexualized Violence Prevention and Response policy.
● For more information about College of the Rockies’ procedures on sexualized violence prevention and response, please review the policy.
Important Notes
● This form is not to be used in an emergency or during an event(s) presenting an immediate threat to the health or safety of yourself or any campus member.
● If you require emergency assistance, please call 911.
● Students living in student housing may also contact an on-duty Community Leader (CL) in an emergency (to be connected with the Student Housing Coordinator).

  • Information about Individual Making the Report (e.g., Survivor, Witness)

  • We recognize that it may be difficult to label an experience of sexual violence. You are not required to label your experience in order to file a report.

  • Please note that unless you provide a contact method, we cannot follow up.

  • Information about the individual alleged to have breached the Sexual Violence and Misconduct Prevention and Response Policy (e.g. Respondent)

  • Other Information

  • Is there any other information you would like to provide? This is not to be used to describe the incident(s). A maximum of 300 characters is permitted.