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Conflict Resolution Policy
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
*
Preferred form of contact
*
Phone
Email
What program are you associated with?
*
Advocacy
After Care
Counseling
CHOOSE Freedom
Diversion
School-Based Diversion
Are you a program participant? Or what's your relationship to the participant?
*
Date of the incident
*
(mm/dd/yyyy)
Location of incident
*
What happened?
*
Who is involved?
*
Were there any witnesses? If so, please include their contact info if possible.
*
How would you hope for this to be resolved?
*
Is there anything else we should know?