Behavioral Infraction Report Form

This form should be used to report potential behavioral infractions as outlined in the DiGRA Code of Conduct. If the situation is an emergency, or you are in imminent danger, please do not use this form and instead contact local police.

If you are in a situation of emergent danger, please call local emergency services before completing this form. This form should be used to report potential behavioral infractions as they are described in the DiGRA Code of Conduct. This form may be completed by any DiGRA member, at any time, with or without prior reporting to a member of the DiGRA Executive Board or Direct Responder. If you prefer, you may request assistance in completing this form by emailing digrainternational@gmail.com. Please click ‘proceed’ to indicate you understand the purpose of this form. If you do not wish to proceed, please close this window.

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Name

If you prefer to make this report anonymously, please leave this section blank. Please know that it will not be possible for investigators to follow up on anonymous complaints.

First Last

If you prefer to make this report anonymously, please leave this section blank. Please know that it will not be possible for investigators to follow up on anonymous complaints.

Date the potential behavioral infraction occurred:(Required)

Approximate time the potential behavioral infraction occured:(Required)

Alleged perpetrator of the infraction:(Required)

Please provide the persons legal name. If the alleged infraction occurred online, please provide their email or screen name in place of first name and write ‘none’ for surname.

First Last

Testimony(Required)

Please provide your testimony of the behaviors which broke DiGRA’s Code of Conduct. Please include as much detail as possible, including information necessary for context.

Please list the names and contact information of any witnesses we should approach to get additional testimony.

Has law enforcement been contacted about this situation?(Required)

Behavioral Infraction Report Form

Behavioral Infraction Report Form

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