Code of Conduct Confidential Reporting
Use this form to report incidents related to the Code of Conduct at UXPALA events, gatherings or meeting (see the Code of Conduct here:
OPTIONAL: Include your name and contact information, or choose to submit a report anonymously. All reports are confidential.
If you would like to reach a Board Member of UXPALA leadership before filling out the form, please email:
CHECK ALL THAT APPLY
What type of violation are you reporting?
Sexual harassment (unwelcome attention and/or inappropriate contact)
Discrimination (acts of racism or homophobia)
Invasion of privacy (intrusive and/or unwanted behavior)
Violence or threatening behavior
Disruptive or drunken behavior
How were you involved in the incident?
I was directly involved
I witnessed the incident
I heard about the incident from someone else
What happened? Please share with us the what, when, where and how.
Please identify the person(s) involved in the incident.
Your name will not be shared with the person involved in the incident, but UXPALA needs to know who was involved in order to conduct a thorough investigation. INCLUDE FIRST AND LAST NAME OF EACH PERSON - IF POSSIBLE. IF THERE WERE MORE THAN 3 PEOPLE INVOLVED, PLEASE USE THE "ADDITIONAL INFORMATION TO SHARE" SECTION AT THE BOTTOM OF THIS FORM.
Person Involved #1
Person Involved #2
Person Involved #3
What is your preferred outcome?
Please note that in all cases, UXPALA will discreetly follow-up on all reports to determine the appropriate course of action including: investigating the incident, warning/barring an attendee from an activity and/or the entire conference.
Preferred Outcome #1
Preferred Outcome #2
Is there anything else that you'd like to share?
How can UXPALA follow up with you?
Meet in person
I do not want to be contacted
If you'd like to be contacted, please choose "OTHER" and provide your email and/or Phone as well as your first name
Thank you for taking the time to submit a report. If you've asked to be contacted, someone will be reaching out soon.
If you have any questions, please reach out to
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