This form should be completed when there is a concern about the conduct of a SEATS member, a member of the community at a SEATS event, or if there has been damage to property at one of our events. Incidents could include: Injury Property damage or loss Interpersonal issue Complaint Contact Person (person completing the report) Name * Role Preferred method of contact * By phone By E-mail Phone number * Email * Complainant Contact Information: (click here if different from above) Name Phone number Email Incident Description: Describe the nature of the incident: * Incident Date: * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20232024 Date incident discovered: Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year202220232024 Location of incident: Estimated number of individuals impacted or involved: Type of individuals affected: Member of SEATS Client Third party/other What would you like to see happen next? * I would like to be contacted I would like to be invited to speak to the board about this issue I would like to know what the results of this complaint are. Thank you so much for your concerns.
