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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.
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* Indicates required question
Where and when did this incident take place?
*
Please provide the name of the event and any specific details about when/where this occurred.
Your answer
What day did the incident occur?
MM
/
DD
/
YYYY
What time did the incident occur?
Please give your best estimate.
Time
:
AM
PM
Which one of these categories matches the incident you are reporting?
Substance
Touch/Consent
Identity
Interpersonal
Emotional
Site Violation
Security
Other…
Clear selection
Who was the other person(s) involved?
*
If you don't know their name, please describe them or share any information that might help us identify them. If you wish to keep their identity confidential, please state so here.
Your answer
What happened?
*
Please provide a detailed description of the behavior you want to bring to our attention.
Your answer
Did anyone else witness this behavior?
If yes, please provide names or identifying information.
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:
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