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Your Report

Please make your report by entering as much information as possible below.

Your company name *

When did this occur? *

Description of the issue *

Is this incident still happening? *

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Have you informed your immediate superior regarding this matter? *

Yes No I do not wish to disclose

Names of the people involved (optional) *

Any witnesses to the incident? (optional) *

Your Anonymity Option

In order to maintain your anonymity, but also with a view to facilitate communication, you may choose one of the following 3 anonymity options.

Anonymous
No personal details are required for the submission of a disclosure and no references to any personal details are included in the Disclosure Report to your organisation.

Partially anonymous
Disclose your contact details to Ethics Asia to facilitate communication should additional information be required. However, your contact details will not be disclosed to your organisation.

Full Disclosure
Disclose your contact details to your organisation to facilitate contact and communication with you directly. This option also allows you to receive status updates from your organisation, if your organisation chooses to do so.

Choose below: *

Anonymous Partially Anonymous Full Disclosure

If you choose Partially Anonymous or Full Disclosure, please provide your contact details below:

Phone Number *

Email *

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Ethics Asia is not an emergency service