Online Reporting Form

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

Health & Safety

  • Related to that of clients and staff
  • Related to quality in the services provided
  • Related to Policies and Procedures in Operations

HIPAA

  • Related to the privacy and security of confidential information

Human Resources (HR) Concerns

  • Training
  • Job Duties
  • Employee Manual
  • Policies and Procedures related to Employment

Compliance

  • Fraud, Waste or Abuse of Funding or Resources
  • Misuse of 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.

Use the form below to submit your 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

    January 2025
    M T W T F S S
     12345
    6789101112
    13141516171819
    20212223242526
    2728293031