Asheville Movement Collective Incident Reporting Form

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Use this form to report consent incidents, including boundary-crossings, inappropriate behavior, harassment or violations of the community's guidelines, experienced or witnessed, at events and beyond. No incident is too big or too small. Reporting builds awareness, strengthens our community and empowers others to do the same. All of your answers will be held strictly confidential to the organizers and Consent Team unless you give explicit consent otherwise.

Where the incident(s) took place:

On the dance floor

On the premises

Outside of the dance premises

Other:

Clear selection

When the incident took place (if you are unsure of the exact date and time, please provide an approximate time):

YYYY

Please describe in more detail exactly where and when did this incident take place? Provide any other specifics about location or timing of incident. *

What happened? Please provide a detailed description of the incident(s) you want to bring to our attention. I.e. What boundaries were crossed? What did you not feel comfortable with?

Who was the other person(s) involved? This could be the boundary crosser and/or the impacted person (if not you). If you don't know their name(s), or if you wish to keep their identity confidential, please state so here. Alternatively, if you would like us to follow up with them, please give their name(s) and any contact information you have for them.

Did anyone else witness this incident or behavior? Please be specific about individuals.

Have you, or do you intend to, follow up with the person(s) involved on your own?

Yes

Undecided

Other:

Clear selection

Do you feel unsafe around the person(s) involved in incident(s)?

Yes

Sometimes

Unsure

Other:

Clear selection

What sort of response would you like?

I would like a facilitated mediation or clearing conversation with the person(s) involved.

I would like to speak with someone on the Consent Team about this privately.

I would like for you to look into this on my behalf, and follow up with the involved parties.

I would like to report and request that the person(s) be removed or barred from dance premises.

I just want you to know about the incident, no follow up is needed

Other:

Do you want to remain anonymous?

Yes

Clear selection

Is there anything else you would like to add?

Your Name (optional) - please include this info if you want us to contact you.

Your Email (optional) - please include this info if you want us to contact you

Your Cell Number (optional)

Is it ok to leave you a voicemail?

Yes

Clear selection

Submit

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