Report form
This Report form serves as part of the Icarus safety network, aimed at providing members with the opportunity to report on unsafe situations and behaviours they have experienced at Icarus. This form is confidential, meaning that only Safe Persons of Icarus can access it. The form can also be filled in anonymously. Keep in mind that filling in this form does not mean that a formal complaint has been submitted — this is just to keep a trail of anything you feel the Safe Persons should be made aware of. If you want to submit a formal complaint as well, you can indicate that preference at the end of the form. Please keep in mind that submitting a formal complaint cannot be done anonymously.
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If you wish, state your name and surname here.
There are currently two Safe Persons working at Icarus: Anastasia Khairova and Joris Schulz-Heienbrok. If for any reason you would like one of the Safe Persons to not work on your case, please state so here.
Please describe in your own words what happened; be as complete as you can and are comfortable with. *
What is the name of the person(s) involved in the incident? *
Are there any witnesses or third persons who were aware of the situation? *
If you would like to be contacted by Safe Persons about the incident, please leave your contact details below.
Please indicate whether you would like to also submit a formal complaint form about this incident. *
Is there anything else you would like to share with us?
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