Sexual Violence Reporting Form

Reports can be submitted through this website at any time; however, if a situation is urgent or you have immediate safety concerns, notify MTSU University Police (on campus: 615-898-2424) (off campus: 911) or call the Rutherford County Domestic Violence & Sexual Assault Program at 615-494-9262.

Incident Information




Person Reporting









Person Harmed













Person(s) Accused













Law Enforcement Involvement

Reported Complaint

Inserting your name in the box below signifies your official signature.  An official signature indicates you are submitting a formal complaint to Middle Tennessee State University.

No signature indicates that you would like to discuss the matter with the Title IX Coordinator as soon as possible.