THIS FORM IS NOT A 911 OR EMERGENCY SERVICE.

Do not use this site to report events presenting an immediate threat to life or property. Reports submitted through this service may not receive an immediate response. If you require emergency assistance, please contact your local authorities.

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* 1. Location where this incident occured

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* 2. Do you wish to remain anonymous for this report?

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* 3. Name (First and Last)

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* 4. Phone Number

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* 5. Email address

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* 6. Best time for communication with you:

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* 7. Is it ok to leave a message?

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* 8. What is your relationship to HVCS?

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* 9. Please identify the person(s) engaged in this incident:

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* 10. Have you previously reported this incident?

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* 11. If yes, then to whom? What was the response?

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* 12. Please provide the specific or approximate time this incident occurred:

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* 13. How long do you think this problem has been going on?

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* 14. How did you become aware of this incident?

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* 15. Please identify any persons who have attempted to conceal this problem and the steps they took to conceal it:

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* 16. * 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.

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