National Federation of the Blind Code of Conduct Report Form

This report form is intended to capture information regarding violations to NFB’s Code of Conduct. Reports may be submitted anonymously, by the affected/harmed individual, by a witness of an incident, or by an obligated responsible leader. Anyone reporting an incident must act in good faith, without malice to the NFB or any individual, and have reasonable grounds for believing the misconduct has occurred. Please note that while anonymous reports will be taken as seriously as all other reports, they are more difficult to verify and closure with the reporting party is not possible. If a reporting party wants to speak with the external investigator but wants to otherwise remain anonymous, that is also possible. If an incident has occurred that is actionable by law enforcement, please report those incidents to the appropriate authorities as soon as possible if the effected/harmed individual chooses this path of healing or as appropriate based on your state laws regarding mandatory reporting.

Reports can also be submitted by telephone, email, or verbally through a responsible leader.

If you complete and submit the below form it will be transmitted to our external reviewer, Tonya Baña, and legal counsel who will perform an independent review and determine if the incident is categorized as sexual misconduct, as those cases are investigated externally. If the report does not trigger external investigation, it will be routed to the Office of the President for further action. Please consult the Violations and Reporting Procedures section of the Code of Conduct for more details. Every effort will be made to maintain confidentiality throughout the process. All reports are encouraged and welcome. While the Federation strongly encourages timely reporting so we can be most proactive against alleged transgressors, we recognize that many barriers may exist to timely reporting. Apart from exceptional circumstances, the Federation accepts reports of sexual misconduct that took place no more than five years prior to the filing of the report. However, when the report involves a minor, the Federation will accept a report filed within five years of the minor turning eighteen. Regardless, individuals are encouraged to file reports as soon as possible and when they believe it is safe to do so. Individuals are encouraged to report not only incidents of sexual misconduct but any retaliation that has occurred as a result of filing a report or participating in an investigation. If the below form is successfully completed, you will receive a confirmation email at the address you specify unless you elect not to receive a copy of your report.

Note: All fields with an asterisk (*) are required.

First and Last Name of Person Filing Report (reporting party): *

Reporting Party Email Address: - Opcional

Reporting Party Phone Number: - Opcional

Do you wish to remain anonymous through the investigation process? *

Are you willing to speak with the external investigator if applicable to your report? (if yes, please include an email or phone number to reach you.) *

To your knowledge, is this the first time a report is being filed for this particular alleged misconduct? *

Name of Individual(s) Harmed: *

If known, please provide contact information for individual harmed: - Opcional

Name of person(s) who is believed to have violated the code of conduct: *

Contact information of individual believed to have violated the code of conduct, to the extent known: - Opcional

To your knowledge, is the alleged perpetrator a member or in any way involved with the Federation? *

Describe the misconduct that occurred with as much detail as possible: *

When and where did the misconduct occur? (Please indicate if the incident(s) occurred at a specific event and/or took place over a period of time.): *

Please list any witnesses with phone numbers and/or email addresses who can provide information about the incident: - Opcional

Outline any additional evidence or information that could be helpful during an investigation. Information may include screenshots, transcripts of conversations, or other sorts of supporting evidence. (Please use this space to share anything else that may be useful for an investigator.) - Opcional

Do you wish to receive an email confirmation of this form submission? Note: If you select “yes” you will receive a confirmation email containing all of the information provided above. - Opcional