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Confidential Staff Report Form

This form is completely confidential. You may choose to remain anonymous.

SECTION 1 - Your details

Do you want to remain anonymous?

A
B

Which branch do you work at?

A
B
C
D
E

SECTION 2 - Nature of the complaint

What is your report about? Select the closest category

A
B
C
D
E
F
G
H
I
J

If you selected Other please describe the category briefly

How serious do you consider this issue?

A
B
C
D

SECTION 3 - What happened

Please describe what happened in as much detail as you are comfortable sharing. Include dates, times, and locations if you know them

When did this happen or when did it start?

A
B
C
D
E

Where did this happen?

A
B
C
D
E
F

SECTION 4 - People involved

Who is involved in this incident? You do not need to name them if you are not comfortable

A
B
C
D
E
F

If you are comfortable, please provide names or descriptions of people involved

Were there any witnesses?

A
B
C

If yes please describe the witnesses without naming them if you prefer

SECTION 5 - Evidence

Do you have any evidence such as photos, documents, or screenshots?

A
B
C

Please upload any evidence here if you have it

SECTION 6 - Previous reporting

Have you reported this to anyone else before submitting this form?

A
B
C
D

If yes what happened when you reported it?

SECTION 7 - What you are hoping for

What outcome are you hoping for?

A
B
C
D
E
F

Is there anything else you want management to know?

Thank you for submitting this report. If you chose to identify yourself, a member of senior management will contact you within 5 working days. All reports are taken seriously regardless of the outcome.