Waterloo Undergraduate Student Association

WUSA Incident Reporting Form

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WUSA Incident Reporting Form2022-09-06T17:02:51-04:00

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 services and other supports can be found
HERE as well.

The form is designed to be completely anonymous to help protect the submitter’s privacy. If one agrees to be contacted regarding the form, then an email must be provided. In this case, the email will be accessible to WUSA’s IT and the parties who have been granted viewing consent. The responsible parties handling the form are required to sign agreements to safeguard sensitive information.

This includes confidentiality and conflict of interest agreements.
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:
  • WUSA Equity Specialists
  • 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.

About

The purpose of this form is to provide information to support Waterloo Undergraduate Student Association’s (WUSA) broader advocacy efforts to improve the experience for marginalized folks on campus. De-identified and/or aggregated information from your submission may be shared with our advocacy partners within WUSA, EDI-R, and/or other relevant units 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. Other individual support can be found at the bottom of this page

Form

(i.e. classroom, building, outside, inside, residence etc.)
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 page .

Terms of Agreement

Available Supports

Peer Support2022-05-12T11:17:42-04:00
Individual Trauma-Informed Support2022-05-12T11:18:16-04:00
Other Campus Supports2022-05-12T11:20:55-04:00
Mental Health Support2022-05-12T11:21:28-04:00

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