INCIDENT REPORT

Thank you for reaching out to us to report the incident. If an incident has occurred and you are currently onsite, please report to a staff member, security or police officer.

If this is an emergency and you are unable to reach the people described above, please contact 9-1-1.

Please note: Should you elect to submit an anonymous complaint; we will not be able to contact you to provide updates on the resolution of the report and it may hinder our ability to investigate the claim fully.

Question Title

* 1. What date did the incident take place?

Date

Time

AM/PM

Question Title

* 2. Do you wish to remain anonymous?

Yes, I wish to remain anonymous

No, I am comfortable sharing certain information about my identity with ASF's executive team, potentially building security and/or law enforcement if necessary