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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:

  • SECTION 2:

    SECTOR + LOCATION
    SECTION 2:

  • SECTION 3:

    WHAT HAPPENED?
    SECTION 3:
  •  - -

  • SECTION 4:

    EVIDENCE OR FOLLOW-UP
    SECTION 4:

  • SECTION 5:

    CONTACT INFO
    SECTION 5:

  •

  • 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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