Report a Concern - Camp Conrad Chinnock

This form is intended for families, staff, and community members who wish to report concerns.

You may choose to submit this form anonymously, but we strongly encourage you to include your name and contact information. Doing so allows us to follow up directly, gather additional context, and ensure your concern is appropriately addressed.

Our organization takes concerns seriously. Reports can be submitted anonymously. Retaliation against anyone who raises a concern in good faith is not tolerated.

Every submission will be reviewed. It may take us some time to get back to you but we are responding as quickly and as thoughtfully as possible.  We thank you for your care and trust in this process.

Sign in to Google to save your progress. Learn more
Type of Concern *
Your relationship to Camp Conrad Chinnock? (check all that apply) *
Required
Please describe the concern or situation you would like to report. *
Share as much detail as you feel comfortable providing.
Who was involved in the situation? *
Names and/or roles if known.  If you are unsure of names, any identifying information that may help is appreciated.
When did this occur? *
Please provide a specific date, approximate timeframe, if it is ongoing or you are unsure.
Have you shared this concern with anyone else in the organization? *
Would you like someone to follow up with you? *
Providing contact information is optional. If you choose to remain anonymous, we will review the information you share but may have limited ability to follow up.
Name
Email
Phone
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Diabetes Camping and Educational Services.

Does this form look suspicious? Report