Ethics Concern Reporting Form

A confidential form for reporting ethics concerns, including the issue description, individuals impacted, requested resolution, and reporter information.

Reporting Preferences

• How would you like to submit this report?
• Consent to process my contact information
  If you choose a named submission, your contact information will be used only to investigate and follow up on this report. Do not include sensitive personal data unless necessary.
• Preferred contact method

Concern Details

• Type of concern
• Brief summary of the concern
  One or two sentences describing what happened.
• Detailed description
  Include what happened, when it happened, where it happened, and who was involved if known. Provide only the minimum necessary details.
• Date of incident
  If the exact date is unknown, provide the approximate date or date range in the description.
• Is this concern ongoing?

Individuals and Impact

• Individuals or groups impacted
  List the individuals, teams, or groups affected, or describe the impact if names are not known.
• Individuals involved or referenced
  Add one entry per person if you know who was involved.
• How were people or the organization impacted?
  Describe any financial, legal, safety, reputational, or workplace impact.

Evidence and Requested Resolution

• Supporting evidence or documentation
  Upload only relevant materials, such as screenshots, emails, or documents.
• Witnesses or others with knowledge
  Include names and brief context only if they are relevant and known.
• Requested resolution
• Other resolution details

Reporter Information

• Your name
  Optional if you want to remain anonymous.
• Your email address
  Used only for follow-up about this report.
• Your phone number
  Optional contact method for follow-up.
• Your relationship to the concern