Whistleblower Report Form

Lutheran Social Service of Minnesota (LSS) is committed to ethical conduct in all relationships, business transactions, and the delivery of service. All allegations of wrongful conduct will be taken seriously and thoroughly investigated. Please use this form to report your concern. LSS promises to confidentially hold all personally identifying information about you and/or others, and to investigate all matters reported through this form. Please note that sharing your name is optional.

This form is intended to report suspected financial violations. If your concern is of a non-financial nature, please contact your manager, Senior Director, Associate Vice President or Human Resources if you are an employee. If you are not an employee of LSS, please reach out to your LSS contact or the Human Resources department for assistance. Human Resources can be reached at 1-800-582-5260 or hr.department@lssmn.org.

Please provide as much information as possible to assure a thorough review of events.

Your name

Relationship to LSS

Phone number

Email address

Person against whom the report of alleged wrongful conduct is being made.

Name

Department of service

Phone number

Email address

Briefly describe the alleged wrongful conduct and how you became aware of it. Please include who, what, when, where and how.

List any witnesses to the wrongful conduct