PLACES, Inc. DEI Bias Incident Reporting Form

PLACES, Inc. Diversity, Equity and Inclusion Bias Incident Reporting Form
Those who have been the targets of, or who witness, a hate or bias incident may use this form to make the DEI Committee aware of these incidents. When the report is submitted it will be received by the DEI Committee and may be forwarded to the appropriate administration according to PLACES policies and procedures. Reports will be reviewed within 24 hours if submitted Monday-Thursday. Please allow for an additional 24 to 48 hours on Holidays or weekends. If the situation is an emergency and threatens the safety of staff, residents, clients or tenants, please first follow emergency and/or safety protocols and follow up with the DEI report. If you wish to remain anonymous, please include as detailed of information as possible in order for the team to appropriately investigate.
Urgency of quest*
- Normal
- Immediate
Nature of Incident
- Racial Bias
- Act of Racism
- Act of Discrimation
- Gender Bias
- Other (Please explain in Description of Incident below)
Persons Involved
Description of Incident

PLACES, Inc. Diversity, Equity and Inclusion Bias Incident Reporting Form