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Incident Report

If you were directly impacted or involved in an incident, please use this form to provide your statement.

Share what you can, in your own words.

Click the button below to begin the report.

Start

Question 1 of 7

Please enter your name.

Question 2 of 7

Please enter your email

Question 3 of 7

When did the incident occur?

Specific date or approximate timeframe

Question 4 of 7

Where did the incident occur?

A

During a Haüs of Bliss event

B

After a Haüs of Bliss event

C

In Discord Server

D

In DMs (Discord/Social media)

E

Other

Question 5 of 7

Please list or describe the involved parties, including any known bystanders.

Usernames are applicable.

Question 6 of 7

Please describe what happened in your own words. You may also include how this incident impacted you.

Question 7 of 7

Is there anything you need right now to feel safer or supported?

Confirm and Submit