The Firewall Network Incident Report
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  • Firewall Incident Report

    If you’ve witnessed or experienced professional retaliation, abuse, discrimination, or coercion—this is your first line of defense. We’re here. We’re listening. And we’ve got your back.
    Firewall Incident Report

  • SECTION 1:

    CONFIDENTIALITY + PERMISSION
    SECTION 1:
  • Would you like to remain anonymous for now?*
  • Do you give permission for this information to be reviewed by a licensed attorney affiliated with The Firewall?*

  • SECTION 2:

    SECTOR + LOCATION
    SECTION 2:
  • Which professional Hub are you part of? (Check all that apply)

  • SECTION 3:

    WHAT HAPPENED?
    SECTION 3:
  • What type of violation or threat occurred? (Check all that apply)*
  • Start Date
     - -
  • Have you already reported this internally?*

  • SECTION 4:

    EVIDENCE OR FOLLOW-UP
    SECTION 4:
  • Do you have documentation?
  • Would you like a lawyer to review this incident for possible legal action?

  • SECTION 5:

    CONTACT INFO
    SECTION 5:
  • Format: (000) 000-0000.

  • PLEASE NOTE

    Your report is encrypted and reviewed only by authorized members of The Firewall Network's legal team. Submitting this form does not create an attorney-client relationship.

    This form is subject to change.

    If your situation is urgent or you fear retaliation, seek legal assistance immediately (locally and not through this form).

    Once you submit this form, you will see a "Thank You" message on the next page. This means it was successfully submitted and received. You will not receive a copy of your responses by email.

    Thank you for standing up for the truth.

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