Caritas Jerusalem Online Reporting Form

The purpose of this form is to submit any complaints or concerns relevant to breaches in Caritas Jerusalem’s Code of Conduct and/or Safeguarding Policy. Even if it is only a doubt or a suspicion, staff must report. And even in the case where you have only witnessed an act (but were not subject to it), it is still your responsibility to report.
All reports will be treated with utmost confidentiality in order to protect both the complainant/survivor as well as the accused during the time of the investigation.
In the form below, you have the option to provide your name and contact information, or to remain anonymous. Even in the case where you are anonymous, Caritas Jerusalem asks that you please share as many details in the complaint as you are aware of so that we can respond more effectively and efficiently.
Do not use this site to report events presenting an immediate threat to life or property. Reports submitted through this service may not receive an immediate response. If you require emergency assistance, please contact your local authorities.

Please provide information as follows:

(* Required fields)

Untitled Board

Location where incident occurred

Physical address, branch and/or store number

* City

* Are you an employee of Caritas Jerusalem?

Yes

No

* Do you wish to remain ANONYMOUS for this report?

Yes

No

If you want Caritas Jerusalem to know your identity, please complete the following:

Your Name

First Name	Last Name

Your Phone Number

Your Email Address

Best time for communication with you

* Please identify the person(s) engaged in this behavior

First Name	Last Name	Title

Do you suspect or know that a supervisor or management is involved?

Yes

No

Do Not Know/Do Not Wish To Disclose

If yes, then who?

Any persons mentioned here will be restricted by EthicsPoint from access to this reported information.

Is management aware of this problem?

Yes

No

Do Not Know/Do Not Wish To Disclose

What is the general nature of this matter?

This should be a general description only, you will be asked for specifics later.

Where did this incident or violation occur?

We recognize that this incident may not have occurred in a particular location. However, if this incident was observed in some documentation or business transactions, please indicate this accordingly.

Please provide the specific or approximate time this incident occurred

* How long do you think this problem has been going on?

* How did you become aware of this violation

Please identify any persons who have attempted to conceal this problem and the steps they took to conceal it

Please identify by name and title.

If you have a document or file that supports your report, most common file types can be uploaded

* Please provide all details regarding the alleged violation, including the locations of witnesses and any other information that could be valuable in the evaluation and ultimate resolution of this situation

Please take your time and provide as much detail as possible, but exercise care to not provide details that may reveal your identity unless you wish to do so. It may be important to know if you are the only person aware of this situation.