NASW Conduct Reporting Form

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Thank you for contacting us to share your concerns or information regarding harassment or other potential violations of the NASW Conference & Meeting Code of Conduct.

We are committed to creating a friendly, safe, and welcoming environment for all NASW participants who engage in NASW activities, so we take this issue very seriously.

ANONYMITY: If you wish to remain anonymous, skip the questions about your identity and contact information. Note that this will make it impossible for us to follow up with you, so please try to give information that is as thorough and detailed as possible.

CONFIDENTIALITY: If you wish for the complaint to remain confidential, you may indicate so below. This means we may contact you for verification or further information (if you indicate your permission below), but we will not name you to the person you are reporting unless you provide explicit permission.

If you prefer not to fill out the form, you may also contact NASW's Accountability Officer, Paula Brantner,* directly at safeconferences@gmail.com or +1 202.688.7297.

*Paula Brantner of Accountability Ignited (formerly PB Work Solutions) has been hired by NASW to receive reports and conduct investigations of potential code of conduct violations. As a neutral third party experienced in working with targets of discrimination and harassment, and as a trained investigator, Paula is present on site in Boulder and will provide you with more information about NASW's code of conduct enforcement process, to help you figure out how to proceed when you've experienced a potential violation.

Please keep this report: *

Anonymous ("I do not wish for you to know my name/identity.")

Confidential ("You may follow up with me, but do not share my name with the person I am reporting or to others outside the reporting process.")

Other:

What is your name (if you are comfortable providing it)? Please leave this blank if you wish to remain anonymous.

What do you want to report? Please be as detailed as possible here. Who were the parties involved? What behavior did you witness, or hear about? Where did it take place? When did it occur? Was the behavior called out? Were there any consequences or follow-up afterwards? *

Where did the behavior(s) or incident(s) occur? (We recognize that this behavior or incident may not have occurred in a particular physical location. However, if this incident was observed in written documents or online, please indicate this accordingly.)

When did the behavior(s) or incident(s) occur?

Were there other witnesses when the behavior(s) or incident(s) occurred? Was anyone else present to witness the behavior(s) or incident(s) that you are reporting? If so, can you tell us who?

Would you like us to contact you to follow up about this report? *

Yes

Prefer not, but yes, if necessary

Other:

What is the best way to contact you (if you are comfortable with someone following up with you)? If you are comfortable sharing this, please provide contact information such as your email and/or phone number. Please leave this blank if you wish to remain anonymous.

Anything else you want to share?

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