USA Volleyball Report a Concern Form

The U.S. Center for SafeSport has exclusive Jurisdiction over allegations of sexual misconduct.

If you are reporting Sexual Misconduct please click the following link to report directly to the U.S Center for SafeSport Click Here

If you are reporting any other form of Misconduct including physical and emotional misconduct such as bullying, hazing, harassment, retaliation, or any other violations of the SafeSport Code, please complete the section below and a representative from USA Volleyball’s Safe Sport Department will review your concern.

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All reports are kept strictly confidential by Safe Sport Program staff. Reports may be submitted ANONYMOUSLY, however reporting anonymously may limit our ability to investigate your concern . A person reporting misconduct should not fear retaliation when filing a report, he/she/they believe is true. Retaliation of a report made in good faith before, during, or after the process is prohibited and is a violation of the U.S Center for SafeSport Code.

Intentionally filing a false allegation is a violation of the U.S. Center for SafeSport Code and may violate state criminal law and civil defamation laws.

First Name of Reporting Party (or Anonymous or Unknown) *

Last Name of Reporting Party (or Anonymous or Unknown) *

Phone (include area code)

Email Address * 🛈

Confirm Email * 🛈

USA Volleyball Member *

Yes

No

Region Affiliation
Click to Find Region

Club Name

Reporting Party Relationship to victim (if any) * 🛈

Self	Club Member
Parent / Guardian	Other Family Member
Coach or Volunteer	Friend or acquantance
Prefer not to say	Other Other

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Person Being Reported (Respondent)

Provide as much information as possible about the person you are reporting.

Respondent First Name *

Respondent Last Name *

Approximate Age

Gender *

Male	Female
Non-binary

Region Affiliation
Click to Find Region *

Club Name * 🛈

Position (s) this person held or holds *

Head Coach	Assistant Coach
Club Director	Official
Athlete	Other Other

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Alleged Offense Information.

Provide as much information as you are able.

Type of Offense (select all that apply) * 🛈

Physical Misconduct

Emotional Misconduct

Bullying, Threats and Harassment

Sexual Harassment

Hazing

MAAPP Violation

Other Other

Location of incident(s) * 🛈

Date (s) of Alleged Offense * 🛈 +

Detailed Description of Incident *

Knowledge of victim (s) involved in the alleged offense *

I am not aware of any victim(s) involved in the alleged offense

I am aware of a victim(s) involved

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Victim

You may also be unaware of who the victim is. In that case, please enter Unknown.

First Name of Victim (or Anonymous or Unknown) *

Last Name of Victim (or Anonymous or Unknown) *

Age or Approximate Age *

Gender *

Male	Female
Non-binary

Club Name (or None)

Additional Information

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Additional Victim(s)

First Name of Victim

Last Name of Victim

Age or Approximate age

Club name (or none)

Gender

Male	Female
Non-binary

Additional Information

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Individual(s) Who May Have Additional Information

List anyone who may be able to provide additional information regarding the alleged offense. We will not identify you when we contact these individuals.

First Name of witness

Last Name of witness

Phone (include area code)

Email Address

Confirm Email

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Your concern will be reviewed by USA Volleyball’s Safe Sport Staff. USA Volleyball’s Safe Sport staff will determine proper jurisdiction and will either forward your concern to the U.S. Center for SafeSport for resolution, or your concern will be forwarded to the Commissioner of your Region for investigation and resolution. If you provide your name and contact information, USA Volleyball Safe Sport Staff will contact you regarding jurisdiction and follow up. If you experience retaliation for making a good faith report before, during or after the process, please let us know immediately by filing another concern.

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