Anonymous Research Misconduct Report

1
Do you want to remain anonymous?* This field is required.
YESNO
2
Name
First Name
Last Name
3
Email
example@example.com
4
Your relationship to Boyce Thompson Institute* This field is required.
Employee
Faculty
Vendor
Other
Prefer not to say
5
Please provide the specific or approximate time this incident occurred:* This field is required.Examples: Tuesday, May 3, 2019 or Two weeks ago or Approximately a month ago
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6
Please identify the person(s) involved.* This field is required.Full name and title/position if possible.
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Where did this incident or violation occur?* This field is required.We recognize that this incident may not have occurred in a particular location. However, if this incident was observed in some documentation or business transactions, please indicate this accordingly.
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8
Do you suspect or know that a supervisor or management is involved?* This field is required.
Yes
No
Don't Know
Don't wish to disclose
9
If yes, who?Any persons mentioned here will be restricted from access to this reported information.
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10
Is management aware of this problem?* This field is required.
Yes
No
Don't Know
Don't wish to disclose
11
What is the general nature of this matter?* This field is required.This should be a general description only, you will be asked for specifics later.
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How long do you think this problem has been going on?* This field is required.
Once
One week
1-3 months
3 months to a year
More than a year
Don't know
13
How did you become aware of this violation?* This field is required.
It happened to me
I observed it
I heard it
Told to me by a co-worker
Told to me by someone outside BTI
Accidentally found a document or file
Other
14
If other, how?
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Are you aware of anyone who has attempted to conceal this problem?* This field is required.Examples: Ignored it, Changed documents, Said it was not a problem, Said they would look into it
Yes
No
N/A
16
If yes, please identify any persons who have attempted to conceal this problem and the steps they took to conceal it:Examples: Ignored it, Changed documents, Said it was not a problem, Said they would look into it
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17
You can submit any files that support your report.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Are there other people who know about this matter who may be able to assist our investigation? If not, please answer N/A.* This field is required.If so, please include their names and contact details and indicate whether they are aware that you have provided their details in this report.
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Please provide all details regarding the alleged violation, including the locations of witnesses and any other information that could be valuable in the evaluation and ultimate resolution of this situation.* This field is required.Please take your time and provide as much detail as possible, but exercise care to not provide details that may reveal your identity unless you wish to do so. It may be important to know if you are the only person aware of this situation.
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