The fields with an asterisk (
*
) are required.
What type of violation are you reporting?
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Gestures, comments (whether verbal, written or otherwise), or other conduct intended to target someone or a group of people’s race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status in a negative or demeaning manner
Inappropriate, unwelcome or unwanted physical contact
Comments, actions or gestures of a sexual nature, including the inappropriate (e.g., non-clinical) use of nudity or sexual images
Stalking
Conduct intended to intimidate or has the effect of being intimidating
Physical or verbal abuse, including without limitation, threats, pushing, shoving, or the use of any physical force against another person
Conduct which is abusive, hostile or demeaning to other speakers or participants
Any conduct which creates a disturbance, and which may be considered dangerous, or creates the reasonable apprehension of danger, in ACR’s sole discretion
Public intoxication
Taking or distribution of (including posting to online media sources) any photographs or videos without the consent of every person who can be seen
Other
How were you involved in the incident?
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I was directly involved
I witnessed the incident
I heard about the incident from someone
Describe what happened - include what, when, and where
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Person(s) involved in the incident
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Your name will not be shared with the person involved, but ACR needs to know in order to conduct a thorough investigation.
What is your preferred outcome?
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ACR will discreetly follow-up on all reports to determine the appropriate course of action including: investigating the incident, warning/barring an attendee from a session and/or the entire meeting.
Is there anything else that you would like to share?
How would you like ACR to follow up with you?
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Phone
Email
Meet in person with ACR representatives, who are trained to help with Code of Conduct issues
I do not want to be contacted
Your Name
Optional - but if you would like ACR to follow up with you, please provide your name
Email
Optional - but if you would like ACR to follow up with you, please provide your email
Phone
Optional - but if you would like ACR to follow up with you, please provide your phone
Please verify that you are human
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