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Thank You For Wanting To Build A Safe Environment
We understand that discussing sensitive topics like this can be challenging, and we appreciate your commitment to creating a safe environment. This form is designed to be confidential, and we won't share any identifying information that you disclose. Your well-being is important to us, and if you need support, our SAFEline is available 24/7 for calls, chats, or texts. You don't have to be in crisis to reach out, and our SAFEline advocates will provide assistance, advice, or just a listening ear.
About You (Optional)
Nominate Your Company for a BASE Training
Who Should We Contact?
EEOC Information: The U.S. Equal Employment Opportunity Commission (EEOC) enforces federal laws prohibiting workplace discrimination. It's important to note that any discriminatory behavior, including sexual harassment, is a violation of these laws. We encourage you to visit the EEOC website ( for more information on your rights and responsibilities regarding workplace discrimination.
Confirmation: By submitting this form, you acknowledge that you have the right to disclose the information provided. We will keep your information confidential and will reach out to the company, but we cannot guarantee they will accept the training. We understand the difficulties you may be facing, and we are here to support you.

Thank you for reaching out! Our team will review your submission and get back to you within 48 hours.

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Please remember, you're not alone, and we're here to help. If you need immediate assistance or just someone to talk to, please don't hesitate to contact our SAFEline 24/7 at (512) 267-7233 or use our chat and text services. You don't have to be in crisis to call, and we're here to provide support, advice, or a listening ear whenever you need it.
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