Code of Conduct Form

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Anonymous?*

Do you wish to remain anonymous during the course of any investigation? AIHA cannot guarantee that you will remain anonymous throughout the course of the investigation; however, we will do our best to protect your anonymity. In some cases, we will need to disclose your identity but we will make you aware of this before doing so.

Approximate Date of the Event prompting this complaint.

Approximate Time of the Event prompting this complaint.

Full details explaining the incident prompting this complaint.

Physically Threatened or Harassed?*

Did complainant feel physically threatened or harassed by person(s) involved prompting this complaint? Any physical threats or physical (or attempted) assaults should be immediately reported to local law enforcement.