Webform Indicates required field Name Email Phone Date of Incident Location of Incident Description of Incident How would you like to be contacted? - Select -EmailPhoneText Have you spoken to anyone about this incident? Yes No How did it go? Do you currently feel safe? Yes No Would you like a member of the DEI taskforce to follow up with you? Yes No Which member of the DEI taskforce would you like to reach out to you? Ashley Holdridge (Athletics) Miguel Pereira (Coordinator for DEI) Julia Rizzo (Director Individual Studies) James Verity (Assistant Professor) Laura Pierie (College Senate President) Leave this field blank Contact Diversity, Equity & Inclusivity Location Helyar Hall Phone 315.684.6981