HAMILTON Restorative & Reparative Remedies Form Survey

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* 1. Date and Time of Incident:

Date / Time

Date

Time

AM/PM

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* 2. Have you previously reported this event?

Yes (Please specify what department and/or person and when you reported the incident.)

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* 3. Please select one of the following:

I experienced bias, discrimination, or harassment.

I witnessed bias, discrimination, or harassment.

I may have been the perpetrator of biased, discriminatory, and/or harassing behavior.

I have been accused of being the perpetrator of bias, discrimination, and/or harassment.

I am involved in an ongoing workplace conflict.

Other (please specify)

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* 4. Please select one of the following:

The incident occurred on HAMILTON company grounds or physical space.

The incident occurred off of HAMILTON company grounds or physical space.

The incident occurred in a HAMILTON virtual space.

The incident occurred in a non-HAMILTON virtual space.

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* 5. Please select one of the following:

Broadway

And Peggy

Angelica

Eliza

Philip

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* 6. Please describe the setting:

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* 7. Nature of the incident: (Please select all that apply.)

Bias: is a preconceived negative opinion or attitude in favor of or against one thing, person, or group of people who possess common physical characteristics or cultural experiences compared with another, usually in a way considered to be unfair.

Discrimination: is the prejudicial treatment of others or the act of treating others differently and unfavorably based on prejudicial or unjustified distinctions in policies, laws, or treatment, usually based on race, ethnicity, nationality, class, caste, religion, belief, sex, gender, language, sexual orientation, gender identity, sex characteristics, age, health or other statuses.

Harassment: includes verbal, visual or physical conduct that denigrates or shows hostility or aversion to an individual because of any protected characteristic when such conduct has the purpose or effect of unreasonably interfering with an individual or third party’s work performance; creating an intimidating, hostile, or offensive work environment; or otherwise adversely affecting an individual or third party’s employment opportunities. Harassment may include but is not limited to: verbal abuse or ridicule, including slurs, epithets, and stereotyping; offensive jokes and comments; threatening, intimidating, or hostile acts, and displaying or distributing offensive materials, writings, graffiti, or pictures. Harassment may include conduct carried out through the internet, email, social media, or other electronic means. Protected categories include age, color, disability, family responsibilities, gender identity and expression, genetic information, marital status, national origin and accent, personal appearance, political affiliation, pregnancy, race, religion, sex, sexual orientation, source of income, veteran’s status, or other factors prohibited by law.

Hate Crime: incidents that are motivated by bias against one’s actual or perceived race, color, religion, national origin, sex, sexual orientation, gender, gender identity or expression, ability, age, marital status, personal appearance, homelessness, or political affiliation of a victim of the subject designated act.

Hate Incidents: acts of prejudice against a protected class that are not criminal and do not involve violence, threats, or property damage.

Hate Speech: public speech that expresses hate or encourages violence towards a person or group based on an aspect of identity, such as race, religion, sex, or sexual orientation; an expression that falsely defames a specific individual or constitutes a genuine threat, or unjustifiably invades substantial privacy or confidentiality interests.

Microagression: Verbal, behavioral or environmental slights that communicate hostile, derogatory, or negative attitudes toward stigmatized or culturally oppressed/marginalized groups.

Microinequity: Behavior that may cause individuals to feel singled out, overlooked, ignored, or otherwise discounted based on characteristics such as race or gender.

Microinsult: Verbal and nonverbal communications that subtly convey rudeness and insensitivity and demean a person's heritage or identity.

Workplace Conflict: a state of discord caused by the actual or perceived opposition of needs, values and interests between people working together.

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* 8. Related factors/context to this incident: (Please select all that apply.)

Ability or Disability

Age or Generation

Ancestry or National Origin

Gender Identity or Gender Expression

Language or Language Expression

Race or Ethnicity

Physical Attribute(s)

Religion or Faith Practice

Sex/Gender

Sexuality or Sexual Orientation

Organizational Hierarchy or Positional Power

Neurodivergence

Political Views or Association

Other (please specify)

None of the above

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* 9. Other witnesses to the incident, if applicable:

Cast Member(s)

Consumer(s)

Contractor(s)

Employee(s)

Other (please specify)

None of the above

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* 10. Description of the incident: (Please provide as much detail as possible.)

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* 11. Restorative + Reparative Remedies Attempted:

I initiated a restorative, peer-to-peer conversation and it was mostly unproductive.

I was asked to participate in a restorative, peer-to-peer conversation and it was mostly productive.

I was asked to participate in a restorative, peer-to-peer conversation and it was mostly unproductive.

I would like support initiating a peer-to-peer conversation.

I have requested or participated in one-on-coaching.

Other individuals involved have requested or participated in one-on-one coaching.

I don't feel safe initiating a peer-to-peer conversation.

I don't feel safe participating in a peer-to-peer conversation.

I don't feel safe participating in a one-on-one coaching session.

Other (please specify)

None of the above

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* 12. Would you like for HAMILTON to respond to the incident?

Yes

I need more information to make a determination.

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* 13. As HAMILTON reviews your report and determines the most appropriate response, your suggestions are welcome. If you have any recommended responses, please detail them below.

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* 14. You may provide your name and request that it be held in confidence as the inquiry goes forward. If you request that your identity remain confidential, persons handling the inquiry will do so to the extent practicable and permitted by HAMILTON policy and applicable laws. HAMILTON'S ability to investigate allegations of misconduct and to take corrective action may be impeded if your identity is not provided to the person responding to the complaint. Depending on the nature of the allegations(s) raised (e.g. unlawful discrimination or sexual violence), conducting a fair and complete investigation may require that the full details of the incident, including your identity, be shared. In those instances, all parties will be advised of HAMILTON'S policy against retaliation for making complaints.

If you wish to remain anonymous, please ensure that the auto-fill is disabled on your web browser. Please close your browser after you have submitted the form. In addition to, or instead of completing this form, you may contact the People & Culture Representative for advice and support.

Yes

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* 15. Contact Information: (Complete only if you do not wish to remain anonymous.)

Name

Email Address

Phone Number

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* 16. Your affiliation with HAMILTON:

Cast Member

Contractor

Employee

Other (please specify)

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* 17. Thank you for completing Hamilton's Incident Reporting Form. The People & Culture Representative will contact you via phone or email.

If you have documents related to this incident, you may upload them here.

HAMILTON Restorative & Reparative Remedies Form

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* 1. Date and Time of Incident:

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* 2. Have you previously reported this event?

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* 3. Please select one of the following:

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* 4. Please select one of the following:

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* 5. Please select one of the following:

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* 6. Please describe the setting:

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* 7. Nature of the incident: (Please select all that apply.)

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* 8. Related factors/context to this incident: (Please select all that apply.)

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* 9. Other witnesses to the incident, if applicable:

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* 10. Description of the incident: (Please provide as much detail as possible.)

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* 11. Restorative + Reparative Remedies Attempted:

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* 12. Would you like for HAMILTON to respond to the incident?

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* 13. As HAMILTON reviews your report and determines the most appropriate response, your suggestions are welcome. If you have any recommended responses, please detail them below.

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* 15. Contact Information: (Complete only if you do not wish to remain anonymous.)

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* 16. Your affiliation with HAMILTON:

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* 17. Thank you for completing Hamilton's Incident Reporting Form. The People & Culture Representative will contact you via phone or email.If you have documents related to this incident, you may upload them here.

* 17. Thank you for completing Hamilton's Incident Reporting Form. The People & Culture Representative will contact you via phone or email.

If you have documents related to this incident, you may upload them here.