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COMMONWEALTH OF PENNSYLVANIA
SEXUAL MISCONDUCT/ABUSE DISCLOSURE RELEASE
(Pursuant to Act 168 of 2014)
Instructions
This standardized form has been developed by the Pennsylvania Department of Education,
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How to fill out sexual misconduct disclosure release
How to fill out sexual misconduct disclosure release
01
Obtain a sexual misconduct disclosure release form from the relevant institution or organization.
02
Read the form thoroughly to understand the information required and the purpose of the disclosure.
03
Begin by providing your personal details such as your full name, address, contact information, and date of birth.
04
Indicate the nature of the sexual misconduct incident you are disclosing, including the date, time, and location of the incident.
05
Provide a detailed account of the incident, including any relevant information about the individuals involved.
06
If there were any witnesses to the incident, include their names and contact information if available.
07
Attach any supporting documentation, such as police reports, medical records, or photographs, if applicable.
08
Sign and date the disclosure release form to certify that the information provided is accurate and complete.
09
Keep a copy of the completed form for your records.
10
Submit the completed form to the designated individual or department, as mentioned in the instructions.
11
Follow up with the institution or organization to ensure that your disclosure has been received and processed.
Who needs sexual misconduct disclosure release?
01
Any individual who has been a victim of sexual misconduct and wishes to disclose the incident to the relevant institution or organization.
02
This includes but is not limited to students, employees, patients, clients, or any other person who has experienced sexual misconduct and wants to seek recourse or justice.
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What is sexual misconduct disclosure release?
The sexual misconduct disclosure release is a document where individuals disclose any incidents of sexual misconduct they have been involved in.
Who is required to file sexual misconduct disclosure release?
Any individual who has been involved in incidents of sexual misconduct is required to file a sexual misconduct disclosure release.
How to fill out sexual misconduct disclosure release?
The sexual misconduct disclosure release can typically be filled out online or in person by providing details of the incident and any relevant information.
What is the purpose of sexual misconduct disclosure release?
The purpose of the sexual misconduct disclosure release is to ensure transparency and accountability regarding incidents of sexual misconduct.
What information must be reported on sexual misconduct disclosure release?
The sexual misconduct disclosure release typically requires information such as the date of the incident, the individuals involved, and any relevant details.
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