Confidential Reporting Form
This form is for confidential reports of harm. It provides a way for CARE to be aware of harms that have occurred/are occurring without necessarily starting an Accountability Process. A confidential report will collect your name and preferred contact information to allow CARE to follow up with you in case additional/similar reports are submitted. Your information will remain strictly confidential to the CARE team and not be shared without your explicit permission. Under the Equitable Justice model the Society uses, the harmed person always has agency is deciding on how to proceed (or not) with an accountability process. By including name and contact information, CARE is able to work directly with you to explore restorative options, if you decide to begin an accountability process.

CARE uses these reports to identify potential patterns of harm by the same person(s) or policies/practices that perpetuate inequities or bias. Submitting this report will not automatically trigger an accountability process. In exceptional cases (specifically acute risk of personal safety), CARE may initiate an accountability process but will always take the utmost care to limit any identifying information included in these reports.
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Please describe the harm or conflict you experienced, you witnessed, or that was relayed to you. You may be as specific or vague as you wish. *
This may be a harm or conflict that happened recently or years ago. It may also be a harm or conflict that is recurring or part of a pattern of harm or conflict.
Name *
Preferred Contact Information *
Feel free to specify an email address, phone number, or other method of contact.
Would you like someone from CARE to reach out to you to discuss options for an Accountability Process? *
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