Consent Incident Report

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form is for reporting behavior that is not in alignment with the agreed upon Etiquette and Protocol of our community. It gives you a record of having reported it, and ensures that we have a record of the incident.

The online entry for this form lives at http://brulee.co/cir

We use this email address below to keep you informed of incident progress. If you wish to remain completely anonymous, you can just use anon@brulee.co as the email address.

Email *

Who are you?

You can leave this blank, but anonymous reports are not immediately actionable.

Who are you in relation to this incident? *

In general, out of respect for the impacted, only 1st person reports are actionable. That said, we value witnesses, upstanders and co-strugglers and will use your Report to help make our community healthier. We cannot improve what we don’t know.

My consent was violated

I violated our Etiquette & Protocol

As an “upstander”, I have witnessed the incident or are submitting this on someone’s behalf.

As a “co-struggler”, I somehow know of this incident.

Anonymous. I do not wish to tell us who you are, but want this information to be known.

Where did this incident happen? *

In general, only incidents that happen in Brulee are actionable. Other Spaces have different Etiquette and Protocols. That said, we welcome any and all information we can use to make our community safer.

In Brulee, Black Rock City

In Brulee, Apogaea

In Brulee, at a camp meeting

In Brulee, somewhere else

Other:

When did the incident happen?

In general, incidents that happened more than a year ago are not actionable. That said, we value every incident report as it helps us to grow and evolve our Etiquette & Protocol.

This incident was...

Incidents more than a year old are generally not actionable beyond being informational.

within the past year.

more than a year ago.

Clear selection

Who was Impacted by this Incident?

Who is Implicated in this Incident?

As a general rule, if you are the Impacted party and are reporting someone, our protocol is to contact the Implicated parties to interview them about their role in the incident.

What happened? *

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Cirque du Kinque. Report Abuse

Forms