Reporting – Protect

Online reporting tool for female workers about mobbing and workplace harassment

Name *

First

Last

Email *

Phone 1

Phone 2

SMS to this number

Chat

Other

Please list the date, activity, and total number of hours. Each new record goes on a new line.

Please provide preferable days/time for communication

No preference.
Other

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Please specify if there is a particular person you would like to speak to (optional)

Please specify if there is someone you do not wish to speak to (optional)

What are your expectations by filling this report?

I want to report one or more incidents and expect measures to be taken by the company.
I want to report one or more incidents and I want to discuss with a responsible officer from the company about my report.
I want support from the company to help me handle my case on my own.
I am not sure yet.
Prefer not to say.
Other

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GIVE US MORE DETAILS ABOUT THE INCIDENT(S) YOU WANT TO REPORT

Prefer not to say

Note: The following closed questions will help us collect information that will enable us to keep track of trends and inform our proactive and preventative actions, whether your report is anonymous or with contact details. Keep in mind that there is the “Prefer not to say” option available.

GIVE US MORE DETAILS ABOUT THE INCIDENT(S) YOU WANT TO REPORT

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When did the incident/s start or take place?

Where did the incident(s) start or take place? (Multiple answers are allowed, choose all that apply)

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Working position/Department/Unit (optional):

Note: If your report is anonymous, we understand that you may not wish to disclose the working position you hold, however we encourage you to disclose some kind of information regarding the department/unit you are connected to or even just the floor.

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What position does the reported party hold in relation to you?

Please describe in your own words, what has happened.

Note: We know that this can be hard but the more information you provide, the more we will be able to help you or others. You can include when, where and what you experienced. Or share if someone else has witnessed the incident. Mention if anyone else was involved. Have you reported this incident to someone else? Have you had prior issues with the person involved? (If yes what kind of prior issues). If you provide names of other individuals, this doesn’t imply that measures or actions will be taken automatically against them. If you have agreed to be contacted by a relevant officer, you will be updated about the actions that we plan to take, and you can decide whether you wish your identity to be revealed or not. If you have chosen to report anonymously or after discussing with the relevant officer you declare that you don’t wish your identity to be revealed, we will protect your anonymity; however, we can use your report to inform our prevention work. Please consider that action may be taken when deciding if you wish to name or include identifiable information about the person/situation you are reporting. You are not required to include this information at this stage, especially if you are filling this report with your contact details and you have agreed to be contacted by a responsible officer.

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How many years are you working in the company/are you collaborating with the company? (Depending on the status mentioned before)

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Please indicate your ethnicity

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Do you have a religion or belief?

Terms and Agreement *

I understand and agree to the terms.

In checking the box above, you agree and confirm that all community service reports are true and accurate. You acknowledge that your service advisor may reach out to the location to confirm your participation.