JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SPX Incident Reporting Form
This form is for the submission of information relating to violations of the SPX Harassment Policy. This information will be kept confidential from the person you are reporting. If you are currently at an SPX-sponsored event we encourage you to approach a member of our staff so that we can take direct action.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please provide your name and preferred contact information
*
We'd like to be able to follow up.
Your answer
Email Address
*
Even if you already provided one above, this field will allow us to send you a confirmation email.
Your answer
Please describe the incident:
*
We understand this may not be pleasant and are terribly sorry to have to even ask such a question but we do need to understand what has occurred so that we can respond appropriately.
Your answer
Please provide an approximate time of the incident:
*
MM
/
DD
/
YYYY
Time
:
AM
PM
What can you tell us about the person(s) you are reporting?
*
For example: name, appearance, table number, etc.
Your answer
Names and contact information for any witnesses?
*
Witnesses are not necessary, but it is helpful to know if there were others we can reach out to.
Your answer
Have you already reported this incident to law enforcement?
*
If not would you like assistance in doing so?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy
Help and feedback
Contact form owner
Help Forms improve
Report