GMCA Online Whistleblowing Form

Anonymity

1. Do you wish to remain anonymous? Guidance *Required

If you have chosen to remain anonymous none of your details will be captured and used in the report.

Yes

Reporting of Concern

2. What is the nature of the concern?

Please give as much detail as possible, including who the allegation is against, location / dates / times of any known incidents/occurrences, other people involved and any potential witnesses.

3. To the best of your knowledge is this still happening? *Required

Yes

Unsure

4. Are you able to provide any evidence to support this referral? If so please outline what evidence is available.

5. If you have evidence in a digital format it can be uploaded here.

6. Have you reported this concern previously? Guidance *Required

Yes

7. If you have reported this previously, when did you report it and who to?

8. Would you be prepared to provide a signed written statement and if necessary, give evidence at a disciplinary hearing or in Court? *Required

If you are asked to provide a statement or give evidence, we will ensure you have the necessary support.

Yes

Maybe