Conduct Concern Report

CONDUCT CONCERN REPORT

You can download this optional form to report allegations of CUAHSI Code of Conduct violations. This form may be submitted to email hidden; JavaScript is required CUAHSI’s Executive Director, CUAHSI’s Board of Directors’ chair, or any Board member. To the extent possible, this matter will be treated confidentially.

A formal report should include the following information:

1. Your Name
2. Your email address
3. Name of accused
4. Accused affiliation with CUAHSI, if known
5. If a victim is involved, please provide name(s) or any other relevant information
6. Witnesses
7. Description of conduct concern- date, time, location, activity
8. Any other facts- including imminent safety concerns
9. Include any other documents or information
10. Sign and date