Sharon Playhouse Anonymous Incident Report Form

Sharon Playhouse Anonymous Incident Report Form
Any person employed by Sharon Playhouse (regardless of pay including employees, staff, and/or volunteer) who has questions or concerns about this policy or a complaint has the option to contact:

• Their supervisor
• Chair(s) of the DEI Committee
• Chair of the Governance Committee
• Human Resources

If none of these options are satisfactory or in the event an individual prefers to file an anonymous complaint, please use this form.

This form will be read by relevant parties and stored securely. If contact information is provided, someone will reach out to you within 24-48 hours.

Please note: The option to identify yourself is included. It is not required.
Date of Incident*

MonthDayYear
Date
Description of Incident (please be as specific as possible):*
Choose which best represents your relationship to the incident:*

This incident happened to meI witnessed this incidentI heard about this incident from another sourceOther
If your selected "Other," please describe:
Optional: Your Name
Optional: Others Involved
Optional: How would you like this incident handled? (This includes special considerations, ideas for solutions, and any people you do or do not feel comfortable included in this conversation)
Is there any other pertinent information readers of this report should be sensitive to?
Are you willing to be contacted regarding this incident?*

YesNo
If yes, what is your preferred method of contact?
Should be Empty: