UNRH Discrimination and Harassment Reporting Form
This form is meant for UNRH participants to personally or anonymously report incidents of discrimination and/or harassment based on gender, gender identity, sexual orientation, religion, race, country of origin, or any other protected class. The report will be viewed by the UNRH Steering Committee. The Committee reserves the right to decide how to proceed with investigating the incident, based on the information provided.
Name (not required)
Your answer
Email Address (not required)
Your answer
Nature of Incident *
Date of Incident *
MM
/
DD
/
YYYY
Location of incident (hotel room, during workshop, at panel, etc.) *
Your answer
Incident Description: please be as specific as possible! *
Your answer
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