LKH Management Incident Report

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LKH Management takes incidents of harassment and/or assault at any of our locations very seriously. If you have felt unsafe, we invite you to fill out this incident report and one of the members of the management team will contact you.

Please note: This form is to be used for incidents that happen ONSITE at a LKH Management location.

Where did the incident took place? *

Hydrate

Elixir Lakeview

Replay Lakeview

Elixir Andersonville

Replay Andersonville

What date did the incident occur? *

YYYY

Approximately what time did the incident occur? *

Time

Please indicate the type of incident that occurred. Select all that apply. *

Physical Abuse

Verbal Abuse

Injury

Sexual Assault

Property Damage/Theft

Harassment

Discrimination (includes, but is not limited to: racism, sexism, ageism, homophobia, transphobia, fatphobia)

Required

Were there any other people involved in this incident? *

Yes

Please describe the incident. Be as specific as possible, including if you have verbally reported this incident to a member of our management team. *

What would you like to see as an outcome to this incident? *

Would you like to be contacted about this request?

Yes

Clear selection

If yes, please provide your email.

Submit

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This form was created inside of LKH Mgmt. Report Abuse

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