OCIC REQUEST TO MAKE A VERBAL REPORT FORM

OCIC REQUEST TO MAKE A VERBAL REPORT FORM

Please use this form if you have experienced an incident or incidents of sexual exploitation, abuse and/or harassment, or if you have witnessed, discovered or suspect an alleged case of sexual exploitation, abuse and harassment by anyone involved with OCIC, while engaged in activities of the Council, and would prefer to make a verbal report. This request will be sent directly to the Executive Director and/or Chair of the Board of Directors. Please note that you are not required to provide your name, if you wish to remain anonymous.
Name

First NameLast (Family) Name:
Phone number
What is the best time of day to contact you? Please note that if we are unable to reach you, we will not leave a voicemail.
Consent to be contacted

OCIC does not tolerate sexual exploitation, abuse and harassment and has a duty of care to ensure that everyone engaged with the Council is treated with dignity and respect, regardless of identity, and is able to safely and equitably access OCIC. We are committed to upholding a survivor-centered trauma informed response to survivors, and will provide referrals to support services that can offer comprehensive quality assistance and support in line with your wants and needs. Assistance will be made available regardless of whether a formal internal response or investigation has been concluded.
I consent to OCIC contacting me for further support.I do not consent to OCIC contacting me for further support.
I consent to this Incident Report being submitted to the*

OCIC Executive Director AND Chair of the Board of DirectorsOCIC Executive Director ONLYOCIC Chair of Board of Directors ONLY
Thank you for submitting this Incident Report.
Should be Empty:

OCIC REQUEST TO MAKE A VERBAL REPORT FORM

Consent to be contacted