Harassment Concern Reporting

Use this form to confidentially report any concerns regarding harassment specifically. Your identity can remain anonymous if you so wish, but all concerns will be dealt with in a secure and confidential manner.

All reports

* Required fields

Your Relationship to the Company * Employee Client Supplier/Vendor Contractor Other (Please specify)

If 'Other', please specify your relationship: *

Do you wish to remain anonymous? * Yes, I wish to remain completely anonymous. No, I am willing to provide my contact information.

If you are willing to provide contact information, please enter your name and email/phone number: *

Date the concern or incident occurred/was observed (or started): *

Location where the concern or incident occurred (e.g., specific department, site, or external company interaction): *

Category of Harassment Concern (Select all that apply) *

Tick all that apply.

Sex Racial Age related Gender Disability Religion/belief Sexual orientation Other (Please describe in detail below)

Describe the concern in detail. Please include who was involved, what happened, when it happened, and any witnesses. Be as specific as possible. Or if the concern is one that you'd like to raise in advance, please give details. *

Do you have any documentation or evidence related to this concern (e.g., emails, photos, documents)? * Yes No

Have you reported this concern previously? If yes, to whom and when?

On a scale of 1 to 5, how urgent do you consider this concern? * 1 — Low urgency 2 3 4 5 — Immediate action required