Reporting incidents form
Thank you for contacting us about your experience at The Plough.This form helps us identify and deal with incidents of discomfort, harm, harassment and violence at The Plough. If possible, we ask you to share as much information as you feel comfortable. This enables us to identify those involved who have caused harm and begin the process of accountability and/or further action. This form is entirely confidential and any names will be redacted from any response going forward. We will not share the details of this form with anyone outside of the organisation. If you request a call back/contact from us, please expect a response within five days. We appreciate and value the time you've taken to fill in this form. 
Sign in to Google to save your progress. Learn more
Name (optional)
Date of incident (if remembered)
MM
/
DD
/
YYYY
Was it reported on the night? If so, to who?
In as much detail as possible - can you tell us what happened?
To help us - do you have specific details of those involved e.g. what they looked like, where it happened in the pub, exact dates, times and location in pub really help us to identify those involved ? 
Would you like to be kept up to date with how we move forward with this incident?
Would you like us to contact you about this? If so, leave us your contact details. 
Is there anything else you would like to tell us?
We are hosting conversations and events with our community surrounding approaches to harm reduction, safety and collective accountability. If you would like to be involved in this, please leave your email below
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy