Share your Experience

This form is a part of WUSA’s broader advocacy initiatives, aiming to enhance campus life for marginalized groups at Waterloo.

When you share your experiences of feeling unsafe, unwelcome, or marginalized, it helps us to develop informed policies and practices that benefit all community members. By strengthening our advocacy efforts, we strive to make the campus environment safer and more inclusive.

Contact Information:

While this form remains anonymous, you now have the option to provide your name and email. We will only follow up when necessary. If you choose to remain anonymous, your submission will still contribute to our research and advocacy initiatives, however, we will be unable to follow up or further support.

De-identified or aggregated details may be shared with advocacy partners, including EDI-R and other relevant campus units. If your safety and well-being are at risk, your contact information may also be shared with relevant campus partners.

Need support?

If you are seeking formal and/or individual trauma-informed support for your specific incident, please consider the following:

Frequently Asked Questions

It is encouraged that instances of equity-related injustice are communicated through the WUSA
Incident Report Form to help inform broader advocacy on the matter. Some examples are instances of:
  • Sexism
  • Racism
  • Transphobia
  • Homophobia
  • Islamophobia
  • Ableism
  • Xenophobia
  • Antisemitism
This form provides WUSA information to support broader advocacy efforts in order to improve the experience for marginalized folks on campus.
If you are also seeking formal and/or individual trauma-informed support for your specific incident, please refer to the form created by the University of Waterloo Office of Equity, Diversity, Inclusion & Anti-racism or contact the Indigenous Relations Office if relevant.
Peer Support and other supports can be found at any of these student-run services:

This form is designed to be anonymous to protect your privacy. However, if you choose to provide your contact information for follow-up, your email will be accessible to WUSA’s IT and authorized personnel who manage this form. These individuals are bound by strict confidentiality to safeguard your sensitive information. Where data is recorded for research purposes, your personal information will not be included. Only if your safety and well-being are at risk will we share your information with relevant campus partners.

Providing your name and email is optional. If you do not include those details, your submission will remain anonymous, and we will be unable to reach out to you for follow-up or further support.

Upon submission of the WUSA Incident Report Form, the form administrator will allow for the parties with whom you have provided consent to access a copy of the form. The subject matter will be used to facilitate broader advocacy with other relevant parties. Mobilization for broader advocacy on equity issues raised by the incident report forms could involve but are not limited to the following
stakeholders:
  • Manager, Advocacy and Stakeholder Relations
  • WUSA Board of Directors
  • WUSA student-run services such as RAISE, Women’s Centre, and Glow
  • Members of the Human Rights, Equity And Inclusion Office
  • Other stakeholders, such as Faculty Deans, AccessAbility Services, and/or additional campus units.
Further questions regarding this form can be directed to the form administrator.

Form

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This field is optional.
This field is optional.
How would you describe this type of injustice?
(i.e. classroom, building, outside, inside, residence etc.) Please be as specific as possible.
Were you directly involved, a witness, or reporting on someone's behalf?
Select all that apply
Consent, Privacy, and Information: The information in this form is sent to the form administrator and distributed appropriately as per the answers you provide below. Details from this form will not be shared without your consent. Thus, agreement below will be important in addressing the incident raised. More information on what to expect from the WUSA Incident Report Form procedure can be found on the FAQ at the beginning of this form.

Terms of Agreement

Do you consent to the form administrator sharing a copy of your form submission with WUSA’s Manager, Advocacy and Stakeholder Relations. so that they can facilitate any next steps in informing WUSA’s advocacy efforts?
Do you consent to the form administrator sharing a copy of your form submission with appropriate UWaterloo departments?
If applicable, please specify who else you feel comfortable accessing a copy of your form to assist in the broader advocacy of your concern

Available Supports

  • If your safety is immediately threatened, call the police at 911 or special constable service at 519-888-4911

  • If you have experienced hate on campus, we encourage you to report it by emailing gethelp@uwaterloo.ca

Campus

Community