EthicsPoint

ETHICSPOINT IS NOT A 911 OR EMERGENCY SERVICE.
Do not use this site to report events presenting an immediate threat to life or property. Reports submitted through this service may not receive an immediate response. If you require emergency assistance, please contact your local authorities.

* Yes - I agree to the Terms and Conditions of making this report.

Please provide information as follows:
( * Required fields )

Organization/Tier:	UHS of Delaware, Inc.
Location where incident occurred:	Physical address, branch and/or store number
City:	State/Province:
Zip/Postal Code:
Country:

* What is your relationship to the company?

* Do you wish to remain ANONYMOUS for this report?

Yes No

If you want UHS of Delaware, Inc. to know your identity, please complete the following:

Your Name:


First Name	Last Name

Your Phone Number:

Your Email Address:

Best time for communication with you:

If you selected Other, please provide details here:

Report - Legacy Case Follow-Up

* Original Report Number / Confirmation Number

* Follow-Up Response

Enter the following into the 'follow-up response' area.
--Date of original report
--Follow-up questions or comments

When you submit the report, you will be issued a Report Key. Please write it down and keep it in a safe place. We ask you to use this Report Key along with the password of your choosing to return to EthicsPoint through the website or telephone hotline in 5-6 business days. By returning in 5-6 business days, you will have the opportunity to review any Follow-up Questions or submit more information about this incident.

Although you will no longer need to use your original Report Number / Confirmation Number and Password / PIN to follow up on your report, we recommend you continue to keep this information in a safe place.

Please choose a password for this report:
* Password:
* Re-enter Password:
Your passwords must match and be at least four characters long.