Contact us about an EDI breach

The survey will take approximately 4 minutes to complete. A person affected by, or who feels to have witnessed, bullying, harassment, sexual misconduct or any other breach of the BNA EDI Policy may file a report via this form.
To the best of its ability, the BNA will keep secret the name of the reporter.

Your name (if you would like to remain anonymous, please enter "Anon") ^* (required)

Contact email address (if you would like to remain anonymous, please enter "Anon") ^* (required)

BNA-affiliated event that this report is concerning ^* (required)

Approximate date of the incident (or of the beginning of the incident) ^* (required)

Description of the incident (please use as much detail as you are comfortable with, and, where relevant describe the ways in which you felt the incident to be a breach of the BNA's EDI Policy - this is not a condition of the BNA acting on the incident, but will help us to do so) ^* (required)

Are there any other possible witnesses who may be able to offer a statement on the incident/breach? Please supply contact email addresses where possible. ^* (required)

Please describe any specific results that you would like the BNA to pursue after you make this report. ^* (required)

Please tick to confirm that you understand that the BNA will process the data you have provided in line with its Privacy Policy and EDI Policy ^* (required)

I understand