Body Shop Member Incident Report

This form is to be used for self-reporting physical consent violations. If you have been a victim of a criminal act (sexual assault, rape, etc), please contact your local authorities.

The information provided in this form is forwarded to the event host(s) for review. Any actions taken will be done so by the event host or their designated liason for reported consent violations.

If you opt-in to be contacted, the event host or their liason should reach out to further discuss the situation. Please direct inquiries about the situation to them.

Any expectation of any outcome should be completely discarded. This form is provided as a tool to communicate possible consent violations to event hosts of sex-positive events.

Your Name*

First NameLast Name

Your Email*

example@example.com

Your Mobile Phone Number*

Please enter a valid phone number.

Would you like to be contacted?*

YesNo

How would you preferred to be contacted?

Phone (voice)Phone (text)Email

Name and contact information of the business/event/organization the incident took place.*

Date and approximate time when incident occurred:*

Date

Hour MinutesAM/PM Option

What type of violation took place?*

Vaginal Penetration (Giving or Receiving)Anal Penetration (Giving or Receiving)Oral Sex (Giving or Receiving)Touching (grabbing/fondling/rubbing genitalia/buttocks/breast/etc)Violence (slapping/hitting/punching/choking, etc)Stealthing/unprotected sexOther

If you don't know the name of the person(s) involved please provide as much information you know about them.*

Incident Location (Please provide specific details):*

Describe in your words, as completely as possible, exactly what happened, as you perceived it. Please keep the information confined to the actual conversation (if any), and the physical components of the incident that took place. *

If there are any witnesses, please provide as much information about them as possible.*

Certification of facts*

I certify that the above information is true and correct.I understand that this report will be automatically forwarded to the event host for review.I understand that the event host is responsible for handling and resolving reports of consent violations.I consent to the use of this information, removing personally identifying information, to be used for educational, research and to help formulate safer standards for various sex-positive industries.

Please verify that you are human*

Consent Violation Reporting