Report Homophobia Online


The form below allows you to report homophobia online. If you need to speak to someone now, visit our Find Help section.

 

Report Homophobia Online

All information below is optional; however, it is much easier to address incidents of homophobia when more information is provided.

Did the incident happen to you or were you an observer?

Me Observer

 

When did the incident occur (date/time)?

 

Where did the incident occur? Please be as specific as possible.

 

Describe the incident including all relevant details. Please be as specific as possible. Please include information, such as if there were others around or if something similar has happened in the past.

 

Have you shared this information with anyone else? If so, who (i.e. friend, RA, University Services)?

 

Were they responsive? If so, in what way?

 

Tell us how to get in touch with you (optional):

Name:

Email:

Phone:

Campus Address:

 

I would like this information kept anonymous.

 

Unless you select either of the following buttons, you will not be contacted and the information will stay with The LGBT Center, Debbie Bazarsky, as a way to document the occurrence of homophobia on campus.

 

Please contact me immediately.

 

I would like to pursue this in a more formalized process. (If so, you will be contacted by Debbie Bazarsky to discuss the appropriate response after confidentially discussing anonymity and other issues.)

 

I do not mind sharing my contact information, but I do not feel the need for much formalized follow-up to this incident.

 

Additional Information (Optional)

 

Undergraduate

Graduate

Staff

Faculty member

Other:

 

How would you describe your sexual orientation?

 

How would you describe your gender?