KU-EHS | Anonymous Concern Report

Timeframe of activity

Location of Occurrence

Provide names of any individuals who are involved in the questionable activity and how:

Describe the activity (please provide as much information as possible):

Describe any physical evidence or documentation you have or are aware:

Describe how you became aware of the activity:

Are there other witnesses to the activity or have you reported the activity to others (please explain):

Would you like for someone from EHS to contact you? If yes, please provide contact information.

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