JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SoulPlay Incident Reporting Form
This is the place to report any incidents of inappropriate behavior you experienced at a SoulPlay event. No incident is too big or too small.
Your courage in sharing will help strengthen our community and make it a safer place for all.
You will be asked at the end of this form if there is any course of action you prefer we take. We commit to respecting your wishes, unless we feel that an intervention is mandatory to prevent future harm.
All of your answers will be held strictly confidential unless you give explicit consent otherwise.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Where and when did this incident take place?
*
Please provide the name of the event, the date and any specific details about when/where this occurred during the event.
Your answer
What happened?
*
Please provide a detailed description of the behavior you want to bring to our attention.
Your answer
Who was the other person(s) involved?
*
If you don't know their name, or if you wish to keep their identity confidential, please state so here.
Your answer
Have you, or do you intend to, follow up with the person(s) involved on your own?
*
Yes
No
Undecided
Other:
What sort of response would you like?
*
I would like a facilitated mediation or clearing conversation with the person(s)
I want you to look into this on my behalf and follow up with the involved parties
I want to speak with someone on the SoulPlay team about this
I just want you to know about the incident, no follow up is needed
Other:
Your details
You may remain anonymous if you choose.
However, if you would like for us to follow up in any way, please fill out the following details:
Your Name
Your answer
Your Email
Your answer
Did anyone else witness this behavior?
If yes, please provide names
Your answer
Thank you for taking the time to make our community stronger and safer for all!
Is there anything else you would like to add?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Soulplay LLC.
Report Abuse
Forms