Harassment Incident Form/APA Events and Activities
We are so sorry you have experienced this harm, please use this form to tell us about what happened so we can deal with the incident and work towards a safer event space. We can follow up with you ASAP. Thanks for your bravery in reporting this incident. This information will be kept confidential.
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What happened, when and where?
We would like to make sure this doesn't happen again. Is it ok that we follow up with the person who caused the harm and take action? 
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May we contact you for more details and perhaps talk about what action should be taken if you are comfortable doing that?
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If yes, please provide your contact information.
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