NOBCChE Incident Report Form

NOBCChE Code of Conduct

Relevant Excerpt:
3. All participants and volunteers should create a welcoming and inclusive environment for everyone, regardless of their background, experiences, or perspectives. This means treating others with courtesy and dignity, avoiding any form of discrimination or harassment, and actively promoting diversity and inclusion. They should refrain from using insulting, harassing, or otherwise offensive language in their NOBCChE interactions. Disruptive, harassing, or inappropriate behavior toward other volunteers, stakeholders, or conference staff is unacceptable. Personal boundaries set by others must be observed. Harassment of any kind, including but not limited to unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment will not be tolerated.

When an incident report is submitted, complete confidentiality is not guaranteed; rather, a reasonable effort will be made to keep your report private. Information will only be shared on a need-to-know basis to conduct a thorough investigation and prevent future incidents, but disclosure to the accused, witnesses, or leadership may be necessary.

• Assault – Physical attack or attempted harm by another person• Sexual Assault – Any non-consensual sexual act or attempt• Sexual Harassment – Unwelcome sexual advances, requests for favors, or other conduct of a sexual nature• Harassment – Bullying, discrimination, intimidation, or repeated unwelcome behavior• Unwarranted or Inappropriate Contact – Any physical contact or interaction that is unwanted or makes you uncomfortable• Injury or Illness – Physical injury or sudden illness occurring during the event (if selected, a new box will populate requesting the attendee’s emergency contact information)• Other – Any other incident not covered aboveOther

Attendee's Emergency Contact Information

Incident Location:*

If at an event, please name the event.

When did this incident occur?*

Please, describe the incident:*

Describe the perpetrator(s) if name (s) not known*

Name of Perpetrator (s), if known)

First NameLast Name

Please attach any additional information that may be useful. All attachments will be kept strictly confidential, and any identifying information will be protected in accordance with NOBCChE’s Code of Conduct policies.

Browse Files

If you would like to be contacted regarding the incident, please fill in the information below.

Name

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number