KSIA - Anonymous report

Instructions: This form is completely anonymous. Please describe your complaint/Report as clearly as possible so that we can analyze it and take the necessary action. Your participation is important to improve our processes and services.

Date the incident or situation occurred *

Description of the situation*

How did this situation affect you personally or how do you think this situation affects others?*

Have you reported this situation to anyone before? *

Yes NO
If you answered "Yes", please indicate who you reported it to and what was the response received.

What do you think could be done to resolve this situation or prevent it from happening again?*

Additional comments*

VERIFICATION CODE *

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Note: This form is strictly confidential and will be used exclusively for the purpose of improving processes and resolving reported problems. No investigations will be conducted into the identity of the sender.

Anonymous Complaint / Report