CSD Incident Reporting

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This form is used to report incidents at Cambridge Swing Dance involving safety, harassment, or anything that might make you feel uncomfortable. Results of this form are only available to the Safety Secretaries.

Would you like to remain completely anonymous? (To both Safety Secretaries, and Complainant) *

Yes

Would you like to remain anonymous to the complainant? (This means we will record this incident, but no individual action will be taken except in the case that there are multiple reports) *

Yes

If you choose to do so, please leave your name:

If you choose to do so, please leave your contact information:

Are you reporting an incident as a third-party or someone who was directly affected? *

I am a third-party

I am / was directly affected by this incident

I am a third-party, and was also directly affected by this incident

Other:

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