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Plateforme de signalement electronique

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– Step 1 of 4

This form is anonymous, the information is processed and analyzed by Sirco.

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Your first name

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Your name

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Your email address

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Residence tel.

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Cell phone

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Work tel.

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Do you agree to be contacted ? *

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No

Instructions for contacting you *

Here you can tell us the best way to communicate with you. (This field is required, if you answered yes to the above question)

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What wrong doing(s) do you wish to report ?

1. Fraud or Financial Misconduct *

Embezzlement or theft
Falsification of financial documents, records, or accounting records
Falsification of accounting records
Unauthorized payment for goods or services that were not provided
Substitution with lower quality goods
Collusion between suppliers
Other (s)

You can choose more than one answer (multiple choice).

2. Corruption and Bribery

Offering, accepting, or soliciting bribes (corruption)
Kickbacks or kickback schemes
Abuse of authority for personal gain
Acceptance of bribes (corruption)
Illegal use of company property

You can choose more than one answer (multiple choice).

3. Harassment and Discrimination

Sexual harassment or misconduct
Discrimination based on race, gender, age, religion, or other protected characteristics
Bullying or hostile work environment

You can choose more than one answer (multiple choice).

4. Health and Safety Violations

Unsafe working conditions
Failure to comply with health and safety regulations
Environmental hazards or violations

You can choose more than one answer (multiple choice).

5. Policy Violations

Breach of company policies or code of conduct
Conflicts of interest
Misuse of company assets or resources
Illegal use of company property
Intentional concealment or misrepresentation of data or facts
Exception to laws, regulations, and frameworks

You can choose more than one answer (multiple choice).

6. Data and Privacy Breaches

Unauthorized access or disclosure of sensitive information
Failure to protect customer or employee data
Misuse of confidential information

You can choose more than one answer (multiple choice).

7. Legal Violations

Violations of applicable laws or regulations
Infringement of intellectual property rights

You can choose more than one answer (multiple choice).

8. Other Ethical Concerns

Any unethical behavior or misconduct that could harm the organization or its stakeholders

You can choose more than one answer (multiple choice).

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Describe the problem *

Who is the victim ? *

Who is involved? (all stakeholders) *

Who are the witnesses? *

List the location(s) where the events took place *

Specify the important events in time *

Describe the methods, manners and modes of operation * *

Provide a description and estimate of the value, costs and amounts involved * *

events took Disclosure

Why do you think this situation happened ? *

Use this section to provide additional information *

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4. Disclosure of this information

Have you communicated all or part of this information…

…to the police? * *

Yes
No

…to someone in the legal field? (e.g. lawyer) *

Oui
Non

…to the media? (e.g. researchers, journalists) *

Yes
No

…to your superior? (at work) *

Yes
No

…to one or more work colleagues? *

Yes
No

…to other people? (not included in the categories above) *

Yes
No

If you answered "Yes" to any of the questions above, describe the people with whom you discussed the information in this report: *

File upload

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Terms of Use and Privacy Policy *

I have read and agree to the terms of use.

By clicking “Send,” you confirm that you have read and accepted our terms of use. You also acknowledge that this report will remain strictly anonymous and that your identity will only be disclosed with your explicit consent. However, please note that this confidentiality will be waived in the event of a false statement. http://www.integreonglobal.ethicsignal.com/privacy-policy/ http://www.integreonglobal.ethicsignal.com/privacy-policy/

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E-mail *

Integreon Headquarters: 830 Morris Turnpike, Suite 402 Short Hills, NJ 07078 Phone: 732-344-0486

e-signalement@sirco.ca

1 (844) 444-0611

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