Abuse complaint submission form

The NOBLE board takes abuse seriously, please feel free to complete this form. Clicking submit sends the complaint to the NOBLE Council. :
* Name: The name you want us to know you as
* Email:
Real Name: If different from the name above
Phone:


Name of the party/s you are complaining about:
(Use the common name used to identify the person within NOBLE)
Date of most recent incident involving your current concern:
Is this an ongoing issue?
Is there multiple issues with this individual?
 
Checklist
Are your needs and limits respected?
Is your relationship built upon honesty, trust and respect? 
Are you able to express your feelings honestly? 
Can you function in everyday life?
Can you refuse to do illegal activities?
Are you free from fear of emotional or physical harm to yourself or others?
Do you feel free to discuss your practices and feelings with anyone you choose?


Informed consent must be judged by balancing the following criteria for each encounter at the time the acts occurred.

For your primary concern:
    1. Was informed consent expressly denied or withdrawn? 
    2. Were there factors which negated that informed consent?
    3. What was the nature of the activity? 
    4. What was the intent of an accused abuser? 
Additional information reguarding your complaint:

Additional information:
Please add any additional information you would like the council to know about.
i.e. repeated incidents, additional incidents, or history.

By Clicking Submit you state the the above statements are true and factual.
You give NOBLE permission to investigate the alligations.