This is a tool to report issues you experienced during the ASA annual meeting which created an unwelcoming climate. The purpose of this tool is to reduce some of the barriers to reporting behaviors or incidents that are perceived as inappropriate so we may become the most welcoming society we can be.

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* 1. I felt:

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* 2. Why do you think you may have been targeted?

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* 3. What was the nature of the experience?

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* 4. If you've experienced inappropriate behavior, was the person someone you think could retaliate against you and potentially have an effect on your career? (Please specify the nature of the relationship, e.g. own supervisor; someone else that can directly affect your career; prominent member of the research field or ASA.)

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* 5. Would you like any action taken to follow up on your report?

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* 6. If yes, what would you like to have happen specifically?

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* 7. Please name the individual, if you would like and if it facilitates your recommended next steps.

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* 8. What actions would you recommend ASA leadership to take to address your concern and prevent similar situations going forward?

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* 9. Would you like to be informed about action taken by the ASA regarding this complaint? Please submit contact information (name, email) if you would like to receive follow-up information. (This may be a pseudonym and non-identified email address.)

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