Forms

form

To report complaints of Title IX and/or Discrimination, Harassment, Interpersonal Violence, & Retaliation, please use the appropriate forms below:

Discrimination, Harassment, Interpersonal Violence, & Retaliation Complaint Form

Advisors:

If an advisor will be present for the meetings or any proceedings, please complete the Advisor Request form and submit it two (2) working days before the meeting to the Title IX Coordinator. The Advisor Guide will assist the Advisor in understanding their role in this process.

Advisor Request Title IX Process

Advisor Guide to the Title IX Process

 

After completing the form, please sign it and send it to:

Title IX Coordinator
Western University of Health Sciences
309 E. Second Street
Pomona, CA 91766
Email: TitleIX@westernu.edu or titleIXCoordinator@westernu.edu