Request for Appointments with DSA-LA Conflict Engagement Team (CET)
Please use this form to request assistance from the DSA-LA Conflict Engagement Team (“CET”). This form is available to all members of DSA-LA and members of closely aligned coalition projects (e.g., NOlympicsLA, Street Watch LA).

CET appointments are available for members who need support navigating conflict, harm, harassment, and other concerns related to organizing in DSA. CET can help you talk through experiences that left you uncomfortable, confused, or frustrated, potentially providing support toward de-escalation, boundary-setting, repair, accountability, and resolution when needed, when possible, and when appropriate. If you feel you have caused harm, harassment, abuse, or violence, you may also use this form to request support in making amends to others or seeking accountability for your own actions.

If you have experienced harm, harassment, abuse, or violence, CET can also help you report that harmful behavior to the National Grievance Officer; understand the national and local grievance processes outlined by DSA National Resolution 33 and DSA-LA’s own misconduct policy, and take steps toward resolution or accountability. You have the option to use this form anonymously.

CET implements national and local misconduct policies while doing our best to align the work with restorative and transformative justice principles. To learn more about this, you can click here and here. Every situation is different, and while not every strategy for healing and accountability is always needed or appropriate, we typically use some amount of goal-setting, storytelling, mediated interpersonal and community conversation, reading/writing/listening/watching, circle work, support teams for survivors, and accountability teams for people who have committed harm. Example resources for restorative practices and navigating interpersonal conflict can be found here and here.

Please answer the following 10 questions so that we can set up an initial appointment with you as soon as possible.
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Your name. Note: If you wish to submit anonymously, you may leave this answer blank. If you opt for this, please remove other identifying information throughout this form.
Email address. Note: If you wish to submit anonymously, you may leave this answer blank. If you opt for this, please remove other identifying information throughout this form. 

We will work on anonymous reports to the best of our ability, but please keep in mind that we have no way of following up with you unless you provide us with contact information.
Name of the person(s) or DSA body (e.g., Committee, Caucus, etc.) with whom you are experiencing conflict. You can also put "anonymous” or “unknown." Please indicate in this section whether you have experienced harm, caused harm, or both.
About how long has this issue been occurring? *
Witnesses or support persons:
Describe the conflict or harm (check all that apply): *
Required
I believe this harassment, abusive behavior, violence, or other harm was on the basis of my/their (check all that apply): *
Required
Please provide us a summary of what has happened; be as specific as possible, including the Who, What, Where, Why, and How of what happened, referencing the categories you selected above. Please try to be as concise as possible while still giving us what we NEED to know. *
If you are the person who has experienced harm - How were you impacted by this experience(check all that apply):
On a scale of 1 to 10, how agitated or distressed are you in regard to this issue?
Not very agitated/distressed
Extremely agitated/distressed
Clear selection
On a scale of 1 to 10, how agitated or distressed is/are the other party/ies involved?
Not very agitated/distressed
Extremely agitated/distressed
Clear selection
The following conflict resolution team members listed below are available to provide support appointments. If you absolutely DO NOT want one of these people to follow up with you, please select their name(s) below:
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