Anonymous Form Report

Durand holds itself and its employees to a high ethical standard. Employees, program participants, family members and community partners are encouraged to report any event, issues, or dealings that negatively impact any of the following areas:

  • Health & Safety of Clients and Staff
  • HIPAA – Privacy and Security of Confidential Information
  • Quality – Striving to Provide the Best Service
  • Human Resources – Knowing Requirements and Following Through
  • Fraud, Waste, Abuse of Resources or Funding
  • Misuse of our Electronic Health Record (Therap)

Reporters have the right to report anonymously. No attempt will be made to identify you. Durand may not – and will not – intimidate, threaten, coerce, discriminate against or take other retaliatory action against a person who files a report.

Please check the box which applies to your report (Check all that apply):

ComplianceHIPAAHealth & SafetyHuman Resources (HR) Concerns

REQUIRED INFORMATION

Today’s Date:

Date of Event:

Location of Event:

Description of Event (as detailed as possible)

OPTIONAL INFORMATION

Name

Phone

Email

CEPA prohibits an employer from taking retaliatory action against an employee who: Discloses or threatens to disclose to a supervisor or a public body an activity, policy or practice of the employer or another employer, with whom there is a business relationship, that the employee reasonably believes is in violation of a law, or a rule or regulation promulgated pursuant to law;

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Durand Executive Offices & Community Services

The staff at Durand come to work each day to educate and empower the students of Durand to help them strive above their disability and to achieve new levels of success and happiness.