Confidential Reporting Form

This is the Lakeland University CONFIDENTIAL reporting form. The information provided will be sent directly to Alex Liosatos, Director of Health and Counseling Center, and a campus advocate.

If you are a victim or know someone who is a victim of any of the following violations you may submit a report by using the form below:

• Sexual Assault
• Dating Violence
• Domestic Abuse
• Stalking
• Harassment
• Discrimination
• Other

If you or someone you know may be in danger or a threat to themselves, please immediately call 911 and/or campus security 920-565-1126.