Sexual Assault/Harassment Information Form

Important Information – Supplying information about a sexual assault to the University.

The University provides a number of options for victims to report and obtain support when they have experienced a sexual assault and/or sexual harassment. The first and preferred method is to make a formal report to one of the support services. Counselling/medical and any other support can be arranged for your safety and welfare. We can then explain and explore options and assist you with any action you decide you want to undertake.

An alternative option, if you decide not to formally report, is to complete this sexual assault/harassment form.

You can choose to

  • complete this form where every question except one is optional;
  • provide your details or
  • complete the form anonymously; or
  • have someone with your authority complete it for you; and
  • submit it confidentially to Respect Now Always.

By using this form you are not making a report to the University to open an investigation.

You are supplying information about what happened to help the University

  • to develop strategies which target incidents of sexual assault and harassment,
  • make the University community safer and reduce the re-occurrence of sexual assault and harassment.

The form is submitted so that you cannot be identified in anyway if you wish to submit the form anonymously, the form is strictly confidential and will be secure within Respect Now Always restricted access files.

This form does not stop you from

  • making a report to the University; or
  • reporting the matter to the Police if you wish to do so.

If this form relates to a person under the age of 18 years, the University as mandatory reporter, must notify the Police and Community Services through the Child Protection Helpline.

Completing this form may be extremely difficult for you as you are being asked to remember, in some detail, what happened. It may be useful to talk with a counsellor before filling it in so you can prepare a few helpful strategies.

The University has a free confidential counselling service and we encourage you to contact this service on 67732897 or visit the Counselling website.

If you would like to make contact with a counsellor other than the University counselling service, or any other form of support call Victims Access Line on 1800 633 063 or Rape Crisis on 1800 424 017. A trained counsellor can discuss your needs and refer you to someone who can help.

At the end of this form, there is a list of support and sexual assault support agencies including support at UNE that you may wish to contact. Please take your time and complete the form with as much information as you can remember. The more accurate the detail the better. If you cannot answer a question, are uncertain or the question does not relate to your situation, move to the next question. If you were assisted by another person to complete this form, please ask them to complete the section at the end of this form.

When you have finished please make note of your Form Submission ID provided at the top of the submission review page or you can print your completed form and click the submit button.

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