CCI Report Form
This form is to be utilized within reasonable expectation and is to be completed as truthfully and wholly as your memory allows for. This Form, it's questions, format, and all documents associated with Consent Culture Initiative (CCI) is proprietary and shall not be duplicated and copied. If this document is to be used as a reference for development of a similar project reasonable attribution should be given to Consent Culture initiative.
The sensitive information in your responses to these questions may be summarized in the case of our monthly debrief to approved Producers including your report, to protect your anonymity.
What is your name and/or nickname?
Only core CCI members are authorized to view responses to this form. Do you wish to remain anonymous to individuals beyond the immediate team members authorized to view this report?
No, I am willing to be named as the reporter, if this report results in a followup and community leadership is informed
Yes, but I would be willing to be named as the reporter to certain specific community leaders I personally trust if this report results in a followup (please list below)
Yes, I wish to remain anonymous to all individuals beyond the people authorized to view this report
If you would prefer to be anonymous to everyone not directly authorized to view this report, except to certain leadership figures you trust, please list those trustworthy people below.
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