APA Incident/Harrassment Report Form

We are so sorry you have experienced this harm. Please use this form to tell us about what happened so we can deal with the incident and work towards a safer event space. We can follow up with you ASAP. Thanks for your bravery in reporting this incident. This information will be kept confidential.

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What happened, when and where?

We would like to make sure this doesn't happen again. Is it ok if we follow up with the person who caused the harm and take action? If so, please let us know who we should follow up with.

May we contact you for more details and perhaps talk about what action should be taken if you are comfortable doing that?

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If yes, please provide your contact information.

Thank you.
Again, we are so sorry this happened. Thank you for sharing your experience with us and helping us to help create safer spaces in the future.
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