Incident Reporting Form

We appreciate your commitment and willingness to keep our community safe. This incident report serves as a formal recording of the facts related to an AFCPE community member incident. Its primary purpose is to uncover the circumstances and conditions that led to the event in order to help prevent future incidents.

If you have any questions or need immediate assistance, please email us at memberservices@afcpe.org.

Reporting Guidelines

What to Report:

Unethical/Inappropriate behavior
Harassment or discrimination
Violations of AFCPE’s policies or guidelines
Accidents
Injuries
Other incidents that compromise safety or integrity

What Not to Report

General feedback or suggestions. Please use the Contact Us form instead.

AFCPE - Incident Reporting Form

Name(Required)

(This is for internal use only so that our team may contact you).

First Last

Email(Required)

(This is for internal use only so that our team may contact you).

Are you submitting this incident report on behalf of yourself or someone else?(Required)

On behalf of myself

On behalf of someone else

If you are filing this incident report on behalf of someone else, what is your relationship to the affected individual?(Required)

Name of affected individual (if different from yourself). Put 'N/A' if this does not apply to you.(Required)

Name of person who complaint is being filed against:(Required)

Email address of person who complaint is being filed against, if known:(Required)

Incident Details

Date of Incident(Required)

Where did this incident occur?(Required)

Type of Incident(Required)

Harassment

Discriminatory harassment

Self-promoting

Bullying/cyberbullying

Stalking/cyberstalking

Use of improper language

Physical harassment

other ((please describe in the 'Detailed description of incident' section below)

Impact of incident on me/the member:(Required)

No impact

I feel/the member feels unsafe

I feel/the member feels as though rules are being broken

I felt/the member felt as though I/they were forced to leave a group

I/the member avoided this person/group

I/the member avoided participating in the member forums

My/the member's mental health was affected

Other (please describe in the 'Detailed description of incident' section below)

Detailed description of incident(Required)

Please include as much detail as available, including date(s), time(s), location(s) names of those involved, and any other specifics that caused you or someone else to feel unsafe or unwelcome.

Please upload photos and/or videos to provide more information related to the incident(s).

Attach any relevant files (e.g., screenshots, photos, emails). File size limit: 50MB.

Drop files here or

Max. file size: 50 MB.

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Incident Reporting Form

Reporting Guidelines

AFCPE - Incident Reporting Form

Incident Details