University Police Sexual Assault Anonymous Report
(All submissions will be kept confidential)
This form is for reporting a sexual assault anonymously to the Buffalo State University Police, to assist with the compilation of statistical records for assaults that occur on the campus. In compliance with the federal Student Right to Know and Campus Security Act. Filing this form will not result in an investigation unless requested. A person who has been assaulted may fill out this form himself or herself and send it to the University Police or may ask a third party (such as a friend or a counselor) to do so.
If the victim needs immediate assistance, please call University Police at (716) 878-6333.
Campus personnel other than those with significant counseling responsibility (such as licensed professionals or certified counselors) must file a report when informed by a student of a sexual assault, to maintain campus compliance with the Federal Crime Awareness Act.
Information on the Victim
Information on the Assault
Information on the Offenders
Person Making Report
Affiliation to Buffalo State
Off-Campus - With Family
Off-Campus - Other
Do Not Fill This Out