Consensuality, Inc. Incident Reporting Form

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Use this form to submit an Incident Report to the Consensuality, Inc. Support Team.

References:

Form Credit: Bonobo Network

Email *

What is your name?

What is your email?

What happened?

Please provide a description of the behavior you want to bring to our attention as well as who was involved.

When and where did it happen?

Let us know date, time, and location as specifically as you can.

Who else witnessed this behavior?

Have you, or do you intend to, followed up with the person(s) involved yourself?

Yes

Undecided

Clear selection

What sort of response would you like?
*

I want a mediation or clearing conversation with the person

I want you to look into this on my behalf and follow up with the involved parties

I want to talk with you, but don't necessarily need you to talk with the person.

I just want you to know about this incident – no follow up is needed

Other:

Required

Submit

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