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: https://uxpala.org/2019/03/uxpala-code-of-conduct/)

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: contact@uxpala.org

INCIDENT DETAILS
CHECK ALL THAT APPLY
What type of violation are you reporting? *
Required
How were you involved in the incident? *
What happened? Please share with us the what, when, where and how. *
Your answer
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 *
Your answer
Person Involved #2 *
Your answer
Person Involved #3 *
Your answer
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 *
Your answer
Preferred Outcome #2 *
Your answer
Is there anything else that you'd like to share? *
Your answer
How can UXPALA follow up with you? *
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 contact@uxpala.org
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