Stanford University
Sexual Assault & Clery Incident Data Form

About This Form

This form was developed to track sexual violence/assault and other Clery reportable crimes at Stanford. It is also being used to track Stanford's response to reported incidents. Information collected from data form submissions are used for statistical purposes only to aid Stanford's prevention and response efforts and in compliance with the Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act. This form will NOT initiate any action by the university or the police. If specifically requested, University officials will direct you to appropriate resources and/or offer other (more formal) reporting options. Further information, including links to important resources, is available below.

Incident Notification Form
Online Form for Stanford Affiliates
Downloadable Form for non-Stanford Affiliates

If you have any questions, please contact: Dr. Laurel Zappert at Counseling and Psychological Services:
  or (650)723-3785. Thank you.

Regarding Sexual Assault Related Incidents

A person who has experienced, or is aware of, a sexual assault, relationship violence, or stalking is urged to make an official report to the Police, the Office of Judicial Affairs, and/or the Associate Vice Provost for Student Affairs. Non-disciplinary and anonymous reporting options are also available. Whether or not you choose to make an official report, you are strongly urged to seek the appropriate help...

  • to ensure your safety
  • and to obtain any necessary academic or work related accommodations.

All of these important considerations pertain whether you have survived a sexual assault or know someone who has. Sexual violence can be a traumatic experience for everyone involved. Click here for further resources.