Confidential Incident Intake Form

Thank you for sharing your story. This form is confidential and will be used to build a confidential database for inquiries for the safety of individuals in their workplaces. This action is to continue the work of holding those who inflict harm accountable. The purpose of this form is to help our community be a safe space. Any possible action by MWA must be consented to, by you. This includes the sharing of information with the party/parties involved in your submission. You can read our confidentiality policy below. We appreciate and are grateful for you sharing your experience.