Disciplinary Incident Report
Members may use this form to report any violations of the HHHA Code of Conduct, the "Zero Tolerance" Alcohol, Drugs, and Controlled Substances Policy, and/or the Rules and Regulations of HHHA to the Disciplinary Committee. This form is not for reporting Safesport Concerns. 

You may report anonymously by omitting your identifying information. However, remaining anonymous may limit the Disciplinary Committee's ability to investigate and/or respond to the information you provide.

Notice of an issue must be reported within 10 days of the incident/violation.
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Date of Incident
 *
MM
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YYYY
Time of Incident *
Time
:
Location of Incident *
Who are you reporting?
 *
Is this member a
 *
Required
What team are they a part of?
 *
Details of Incident/Violation
 *
Please include as much detail as possible
Acknowledgement *
I affirm that the information provided by me is true and complete to the best of my knowledge. I understand and have abided by the HHHA Disciplinary Policies and Procedures for reporting incidents/violations within the 10 day reporting time frame. I understand the 10 day reporting time frame does not apply to incident/violation of child abuse or sexual abuse/misconduct. Child abuse and sexual abuse/misconduct should be reported immediately to US Center for Safesport (833) 587-7233 and the Westminster Police (303) 658-4360.
Required
Would you like to provide your contact information? *
You may report anonymously by omitting your identifying information. However, remaining anonymous may limit the Disciplinary Committee's ability to investigate and/or respond to the information you provide.
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