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Self Report

Dignity at Study

If you or another person are at immediate risk of harm, please contact the Police on 999.

Students’ Dignity at Study Reporting Form: Self Report

I want to report something that happened to me

This form is for the reporting of unwanted behaviours including incidents of bullying, harassment, discrimination, victimisation and/or sexual misconduct, where the person(s) involved is a member of the university community, including a student, member of staff, a visitor or contractor.

You can also report in person should you choose.

The Dignity at Study Champions are based within the university’s student Wellbeing Service, The Life Lounge, Chancellors Building, Eagle Tower, T2. You can call in Monday-Friday 8:45am-5pm (excluding bank holidays)

Once you submit the reporting form, it will be reviewed by the Dignity at Study Policy Coordinator and/or the Dignity at Study Champions. We will aim to contact you within 5 working days by telephone to arrange an initial, confidential meeting with a trained Dignity at Study Champion. This meeting is a safe space to talk through your experience and explore the support available to you, along with any options you may wish to consider going forward.

Please remember:

Taking part in this process is entirely your choice. You can change your mind and withdraw from it at any time. however, once submitted, a copy of your report will be kept on file.

If you have experienced unwanted behaviours from others outside of the university community, you can find out more information about the support available to you, including external services and resources via our Student Safety webpage here: https://www.bolton.ac.uk/student-area/student-safety

Privacy Notice

The University of Greater Manchester is committed to protecting your privacy.

This form collects personal and sensitive information so that we can respond to your report and provide appropriate support. Your data will be processed in line with the UK GDPR and the University’s Data Protection Policy.

Information you provide will be stored securely and shared only with relevant internal services or external partners where necessary and appropriate.

If your report relates to a risk of harm, we may need to act without your consent to safeguard you or others.

For full details, please refer to our University Privacy Notice.

By submitting this form, you confirm you understand how your information will be used.

For more information, please refer to our University Privacy Notice.

Self-Reporting Form

SECTION 1A: YOUR DETAILS

*Indicates a response is required

SECTION 1B: ABOUT YOU

These optional questions help us better understand who is affected by unwanted behaviours, so we can develop better more inclusive support, and address any inequalities.

Your answers will not affect the outcome of your report or the support you receive.

Do you have a disability?

The Equality Act 2010 describes a disabled person as:

“…anyone who has a physical, sensory or mental impairment, which has a substantial and long-term adverse effect on their anility to carry out normal day to day activities.”

SECTION 2A: ABOUT THE INCIDENT

The following section is about what happened. Please complete in as much or as little detail that you feel comfortable with.

*Type of concern

Please select the options that you feel apply to your experience.

Please tick any of the options below that apply. If you’re unsure, you can leave this section blank.

Please use the space below to tell us what happened in your own words. You can share as much or as little as you feel comfortable with. There is no right or wrong way to describe it. If you are unsure of dates or details, that’s ok, just let us know what you can remember.

SECTION 2B: PERSON(S) INVOLVED (optional)

This section is about the person or people you are reporting.

You can provide as much or as little information as you feel comfortable with. This helps us understand what happened and take the appropriate steps to support you. If you don’t know all the details, that’s ok, just tell us what you can.



WITNESSES OR OTHER PEOPLE PRESENT

if anyone else saw or heard what happened, or if you spoke to someone soon after, please tell us about them. This could be another student, staff member, or someone else who knows what happened. We may reach out to the person(s) to extend support if/when appropriate.

THANK YOU FOR COMPLETING THE DIGNITY AT STUDY REPORTING FORM

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