VSS Assault Pre-Report

Please fill out this form so that a VSS representative can contact you.

    1 - I am a victim

    My identity:

    You may provide your name if you wish. If not, leave the field below blank. If you choose to remain anonymous, please note that no action can be taken. However, your report will be recorded.

    In your opinion, is the violence still going on?

    Would you like to be contacted:

    If so:


    2 - The VSS Act as Applied

    The VSS Act: Type and Context:

    Nature of the VSS incident experienced

    Nature of the VSS transaction, if other:

    Background Information

    Other context:

    Author's Identity:


    If you know the author's identity and would like to share it, please fill in the text field below

    Identity of potential witnesses:


    If you know of a potential witness and would like to report it, please fill out the text field below

    3 - Your trusted advisor

    This preliminary report form will be forwarded to one of the Faculty's VSS coordinators. Who would you like it sent to?

    We commend you for taking this step—you are brave. We thank you for your trust; this form will be forwarded to the person you have chosen. If you have specified this, that person will contact you as soon as possible to discuss the matter, and we are committed to supporting you moving forward:  

    • Conducting an assessment of the current situation
    • Completeness of the University of Montpellier's profile 
    • Explanation of Possible Steps

    And if you still need to speak with a VSS advisor later on, they will always be available.

    Otherwise, we recommend that you reach out to someone so you can talk about your situation (a loved one, a healthcare professional, law enforcement, etc.) 

      1 - Witness

      My identity:

      You may provide your name if you wish. If not, leave the field below blank. If you choose to remain anonymous, please note that no action can be taken. However, your report will be recorded.

      My perspective on acts of violence:

      In your opinion, is the violence still going on?

      2 - The VSS Act as Applied

      The VSS Act: Type and Context

      Nature of the VSS incident experienced

      Nature of the VSS transaction, if other:

      Background Information

      Other context:

      The victim's identity:

      If you know the victim's identity and would like to provide that information, please fill in the field

      Is the victim informed of your preliminary reporting process?

      If so, would the victim agree to be contacted again?

      If so, you can enter their contact information here

      Author's Identity:


      If you know the author's identity and would like to share it, please fill in the text field below

      Identity of potential witnesses:


      If you know of a potential witness and would like to report it, please fill out the text field below

      3 - Your trusted advisor

      This preliminary report form will be forwarded to one of the Faculty's VSS coordinators. Who would you like it sent to?

      We commend you for taking this step—you are brave. We thank you for your trust; this form will be forwarded to the person you have chosen. If you have specified this, that person will contact you as soon as possible to discuss the matter, and we are committed to supporting both you and the victim moving forward:  

      • Conducting an assessment of the current situation
      • Completeness of the University of Montpellier's profile 
      • Explanation of Possible Steps

      And if you still need to speak with a VSS advisor later on, they will always be available.

      Otherwise, we recommend that you reach out to someone so you can talk about your situation (a loved one, a healthcare professional, law enforcement, etc.)