Statement of Appropriate Conduct Incident Report Form

The Medical Library Association values the involvement of everyone in our community. We are committed to creating a friendly and respectful place for learning, teaching, and contributing. All participants in our events and communications are expected to show respect to others. If you feel that the Statement of Appropriate Conduct has been violated in an MLA event or online space, please complete this form to report the incident. MLA respects everyone’s right to privacy. You may complete this form anonymously or you may provide your contact information and we will keep it confidential. If you need immediate assistance, please contact the MLA Executive Director on his direct line at 312-419-9095. Thank you for reporting an incident to us. If you provided your personal information, an investigative team member will follow up with you. Please press “Submit” to send this incident report to MLA.

1. Which of the following specifically prohibited behaviors are you reporting on? Check all that apply:(Required)
6. May we contact you with confidentiality to further investigate the incident?
7. Would you like to receive updates about the status of the incident you are reporting?
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Time(Required)
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