Devil Mask Studio Reporting Form

Devil Mask Studio Reporting Form
This form will be delivered to an encrypted email account that is monitored by Nora (ordinals) - nobody else has access. As much as possible, your report and personal information will be kept secure and private.

All reports are taken very seriously. If you share a name and contact information, you will receive an initial personal response within three days of submission.

You may report anonymously, but it will limit the extent to which DMS can work with you to resolve any issues.
What kind of report are you making?*

Consent incident with one or more individual(s)Event incident - a violation of policy or issue with organizer behavior outside of a consent violation
I am:*

Directly involved in this incidentMaking this report on behalf of someone else with their knowledgeMaking this report on behalf of someone else without their knowledge
Who was involved?*
type "N/A" if you would prefer not to name the individual(s)Please share the name(s) and if they were hosts, attendees, guests, instructors, students, etc.
Which event was it?*
Where did this incident take place?*
At the Studio? Offsite?
When did this incident take place?*
To the best of your recollection, please tell us when it happened. Month and year at least are very helpful.
What happened?*
To the best of your recollection, please describe as much of what occurred as you are comfortable sharing.
Have you, or do you intend to, address this with the person(s) involved yourself?*

YesNoUndecided
Do we have your consent to address this with the person(s) involved?*

YesNo
Next actions:

You are always free to change your mind about these actions. There is no guarantee that your request can be met but this is the start of the conversation, not the end.
Do you currently know what you would like to have happen as a result of this report?*

Yes, I have a specific idea of what I would like to happen and I would like to outline itNo, I would like some suggestions of what's possible
Some possible actions:*

I want to have a mediation or clearing conversation with the person(s) involvedI want you to look into the report and have a conversation with the person(s) involved on my behalf (without me involved)I want to have a conversation with Studio staff, without necessarily following up with the person(s) involvedI want this information recorded for future reference, no follow up action neededOther
Please outline the action you want taken as a result of this report: *
Some options: record this incident for future reference, investigate for possible further action, participate in an accountability process...
Are you comfortable sharing your name?*

YesNo - I would prefer to stay anonymousI would prefer you work with my representative
Your Name (or nickname)*

First NameLast Name
Are you OK being contacted to follow up?*

YesNo
What is the best way to contact you?*

PhoneTextEmail
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Your Email*
example@example.com
Representative's Name (or nickname)*

First NameLast Name
What is the best way to contact your representative?*

PhoneTextEmail
Representative's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Representative's Email*
example@example.com
Should be Empty: