Reporting Sexual Misconduct Form

Reporting Sexual Misconduct Form

Please provide details about the incident you wish to report.
The purpose of this report is to make sure we have accurate information around accusations of sexual misconduct involving adults 18 or over and occurring at an Ohio Valley Yearly Meeting event.

DIRECTIONS: Please complete this report as best as possible. Drawings or other non-verbal forms of expression are acceptable if preferred and can be scanned and uploaded to this form.

A confidential response and action steps laid out in OVYM policy will be initiated upon receipt of the completed, signed report.
Date and Time of Incident*

MonthDayYear
Date
Hour MinutesAM/PM Option
Location of Incident*
Name(s) of individual(s) directly involved in the incident:
Witnesses, if any:
Describe the Incident*
Can you express the impact this conduct has had on you, as you understand it at the present time?
Recommendations (if any):
Reported by: *

First NameLast Name
Reporter's Email Address (helpful to our response team)
example@example.com
Your Phone Number (helpful to our response team)
Please enter a valid phone number.Format: (000) 000-0000.
I prefer a phone call.I prefer text messages to my phone.I prefer an e-mail message.
Date of report

MonthDayYear
Date
Upload any supporting files (photos, documents, drawings, etc.)

Cancelof
Ohio Valley Yearly Meeting takes every complaint of harassment or misconduct very seriously. A person making a complaint is encouraged to provide as much information and detail as he or she can to assist the yearly meeting in handling the complaint. Retaliation against an individual for reporting an incident is not acceptable. Please note that a deliberately false or malicious complaint is considered to harm our communities by disrupting feelings of safety and harmony a serious matter.
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