{"id":15689,"date":"2023-12-18T08:24:43","date_gmt":"2023-12-18T07:24:43","guid":{"rendered":"https:\/\/www.hasco-lek.pl\/report-form\/"},"modified":"2026-02-24T15:11:23","modified_gmt":"2026-02-24T14:11:23","slug":"report-form","status":"publish","type":"page","link":"https:\/\/www.hasco-lek.pl\/en\/report-form\/","title":{"rendered":"Report Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"15689\" class=\"elementor elementor-15689 elementor-13416\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f7b7df8 e-flex e-con-boxed e-con e-parent\" data-id=\"f7b7df8\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-74b92e3 elementor-widget elementor-widget-breadcrumbs\" data-id=\"74b92e3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/www.hasco-lek.pl\/en\/\">Strona g\u0142\u00f3wna<\/a><\/span><\/span><\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1722428 e-flex e-con-boxed e-con e-parent\" data-id=\"1722428\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-48b2d4c elementor-widget elementor-widget-heading\" data-id=\"48b2d4c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Report Form (RF)<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ed28aa0 elementor-widget elementor-widget-spacer\" data-id=\"ed28aa0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76a73e2 elementor-widget elementor-widget-shortcode\" data-id=\"76a73e2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f15688-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"15688\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/15689#wpcf7-f15688-o1\" method=\"post\" class=\"wpcf7-form init wpcf7-acceptance-as-validation\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"15688\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f15688-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_uacf7_hidden_conditional_fields\" value=\"\" \/><input type=\"hidden\" name=\"_uacf7_repeaters\" value=\"\" \/><input type=\"hidden\" name=\"_uacf7_options\" value=\"\" \/>\n<\/fieldset>\n    <style>\n                .uacf7-multistep-row .steps-form .steps-row .steps-step.step-complete .btn-circle,\n        .progressbar-style-4 .steps-form .steps-row .steps-step.step-complete .btn-circle {\n        \tbackground-color: #004f9f!important;\n        }\n                <\/style>\n\t\n\t<style>.uacf7-prev, .uacf7-next, .wpcf7-submit{padding-top:px !important; padding-bottom:px !important; padding-left:px !important;  padding-right:px !important;}  <\/style>\t\t\t\t\t<div class=\"uacf7-steps steps-form\" style=\"display:none\">\n\t\t\t\t\t\t<div class=\"steps-row setup-panel\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t<a title-id=\".step-1\"\n\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\thref=\"#15688step-1\"\n\t\t\t\t\t\t\t\t\t\ttype=\"button\">\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t<a title-id=\".step-2\"\n\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\thref=\"#15688step-2\"\n\t\t\t\t\t\t\t\t\t\ttype=\"button\">\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t<a title-id=\".step-3\"\n\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\thref=\"#15688step-3\"\n\t\t\t\t\t\t\t\t\t\ttype=\"button\">\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t<a title-id=\".step-4\"\n\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\thref=\"#15688step-4\"\n\t\t\t\t\t\t\t\t\t\ttype=\"button\">\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t<a title-id=\".step-5\"\n\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\thref=\"#15688step-5\"\n\t\t\t\t\t\t\t\t\t\ttype=\"button\">\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t<a title-id=\".step-6\"\n\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\thref=\"#15688step-6\"\n\t\t\t\t\t\t\t\t\t\ttype=\"button\">\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t<style>\n\t\t.steps-form .steps-row .steps-step .btn-circle {\n\t\t\twidth: 58px;\t\t\theight: 10px;\t\t\tborder-radius: 50px;\t\t\tline-height: 10px;\t\t\tbackground-color: #c9e7f7 !important;\t\t\t\t\t\tfont-size: 60px;\t\t}\n\n\t\t.steps-form .steps-row .steps-step .btn-circle img {\n\t\t\tborder-radius: 50px !important;\t\t}\n\n\t\t.steps-form .steps-row .steps-step .btn-circle.uacf7-btn-active,\n\t\t.steps-form .steps-row .steps-step .btn-circle:hover,\n\t\t.steps-form .steps-row .steps-step .btn-circle:focus,\n\t\t.steps-form .steps-row .steps-step .btn-circle:active {\n\t\t\tbackground-color: #004f9f !important;\t\t\t\t\t}\n\n\t\t.steps-form .steps-row .steps-step p {\n\t\t\tfont-size: 60px;\t\t}\n\n\t\t.steps-form .steps-row::before {\n\t\t\ttop: 5px;\t\t}\n\n\t\t\t<\/style>\n\t\t<style>\n\t\t.uacf7-form-15688 .step-content .uacf7-next,\n\t\t.uacf7-form-15688 .step-content .uacf7-prev\n\t\t{\n\t\t\tbackground-color: #47baec;\n\t\t\tcolor: ;\n\t\t\tborder-color: #47baec;\n\t\t\tborder-radius: 25px;\n\t\t}\n\t\t.uacf7-form-15688 .step-content .uacf7-next:hover,\n\t\t.uacf7-form-15688 .step-content .uacf7-prev:hover\n\t\t{\n\t\t\tbackground-color: #47baec;\n\t\t\tcolor: ;\n\t\t\tborder-color: #47baec;\n\t\t}\n\t<\/style>\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uacf7-steps steps-form \">\n\t\t\t\t\t\t\t<div class=\"steps-row setup-panel\">\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t\t<a title-id=\".step-1\"\n\t\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\t\thref=\"#15688step-1\" type=\"button\"\n\t\t\t\t\t\t\t\t\t\t\tclass=\"btn uacf7-btn-active btn-circle\">1\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"steps-info\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t\t<a title-id=\".step-2\"\n\t\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\t\thref=\"#15688step-2\" type=\"button\"\n\t\t\t\t\t\t\t\t\t\t\tclass=\"btn uacf7-btn-default btn-circle\">2\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"steps-info\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t\t<a title-id=\".step-3\"\n\t\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\t\thref=\"#15688step-3\" type=\"button\"\n\t\t\t\t\t\t\t\t\t\t\tclass=\"btn uacf7-btn-default btn-circle\">3\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"steps-info\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t\t<a title-id=\".step-4\"\n\t\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\t\thref=\"#15688step-4\" type=\"button\"\n\t\t\t\t\t\t\t\t\t\t\tclass=\"btn uacf7-btn-default btn-circle\">4\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"steps-info\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t\t<a title-id=\".step-5\"\n\t\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\t\thref=\"#15688step-5\" type=\"button\"\n\t\t\t\t\t\t\t\t\t\t\tclass=\"btn uacf7-btn-default btn-circle\">5\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"steps-info\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"steps-step\">\n\t\t\t\t\t\t\t\t\t\t<a title-id=\".step-6\"\n\t\t\t\t\t\t\t\t\t\t\tdata-form-id=\"15688\"\n\t\t\t\t\t\t\t\t\t\t\thref=\"#15688step-6\" type=\"button\"\n\t\t\t\t\t\t\t\t\t\t\tclass=\"btn uacf7-btn-default btn-circle\">6\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t<div class=\"steps-info\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uacf7-multisetp-form\">\n\t\t\t\t\t\t\t<style>\n\t\t\t\t\t.uacf7-uacf7style-15688 label {\n\t\t\t\t\t\tcolor: #004f9f;font-size: 16px;font-family: Source Sans Pro, sans-serif;font-style: normal;font-weight: 500;padding-bottom: 8px;\t\t\t\t\t}\n\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"email\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"number\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"password\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"search\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"tel\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"text\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"url\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"date\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"radio\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"checkbox\"],\n\t\t\t\t\t.uacf7-uacf7style-15688 select,\n\t\t\t\t\t.uacf7-uacf7style-15688 textarea {\n\t\t\t\t\t\tcolor: #b5b5b5;font-size: 16px;font-family: Source Sans Pro, sans-serif;font-style: normal;font-weight: normal;height: 52px;border-color: #c9e7f7 !important;border-style: solid!important;margin-bottom: 32px;\t\t\t\t\t}\n\n\t\t\t\t\t.uacf7-uacf7style-15688 .wpcf7-radio span,\n\t\t\t\t\t.uacf7-uacf7style-15688 .wpcf7-checkbox span {\n\t\t\t\t\t\tcolor: #b5b5b5;font-size: 16px;font-family: Source Sans Pro, sans-serif;font-style: normal;font-weight: normal;\t\t\t\t\t}\n\n\t\t\t\t\t.uacf7-uacf7style-15688 textarea {\n\t\t\t\t\t\t\t\t\t\t\t}\n\n\t\t\t\t\t.wpcf7-form-control-wrap select {\n\t\t\t\t\t\twidth: 100%;\n\t\t\t\t\t}\n\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"submit\"] {\n\t\t\t\t\t\tcolor: #ffffff;background-color: #47baec;font-size: 16px;font-family: Source Sans Pro, sans-serif;font-style: normal;font-weight: 500;border-style: none;border-radius: 25px;width: 200px;padding-top: 8px;padding-right: 24px;padding-bottom: 8px;padding-left: 24px;\t\t\t\t\t}\n\n\t\t\t\t\t.uacf7-uacf7style-15688 input[type=\"submit\"]:hover {\n\t\t\t\t\t\tcolor: #ffffff;background-color: #47baec;\t\t\t\t\t}\n\n\t\t\t\t\t\t\t\t\t<\/style>\n\n\t\t\t\t<div class=\"uacf7-uacf7style uacf7-uacf7style-15688\"><div class=\"uacf7-form-wrapper-container uacf7-form-15688  uacf7-uacf7style uacf7-uacf7style-15688\">\t\t<div class=\"uacf7-step uacf7-step-15688 step-content\"\n\t\t\tnext-btn-text=\"Next\" prev-btn-text=\"Previous\">\n\t\t\t\n\n<h4>1. GENERAL INFORMATION<\/h4>\n<label>Legal basis<\/label>\n<ol style=\"font-family:Source Sans Pro;font-size:16px;color:#004f9f;\"><li>Directive (EU) 2019\/1937 of the European Parliament and of the Council of 23 October 2019 on the protection of persons who report breaches of Union law (EU Whistleblowing Directive) <\/li><li>Act of 14 June 2024 on the protection of whistleblowers <\/li>\n<\/ol>\n<br><br><label>Date of completing the form<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"data_wypelnienia\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"2026-05-20\" type=\"date\" name=\"data_wypelnienia\" \/><\/span>\n\n<label>Reported party<\/label>\n<span style=\"font-size:12px;'\">Enter the first and last name or the company name to which the Report relates <\/span><br><span class=\"wpcf7-form-control-wrap\" data-name=\"podmiot_zgloszenia\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"podmiot_zgloszenia\" \/><\/span>\n\n<label>Subject of the Report<\/label>\n<span style=\"font-size:12px;'\">In accordance with Art. 3(1) of the Act of 14 June 2024 on the protection of whistleblowers  <\/span><br><span class=\"wpcf7-form-control-wrap\" data-name=\"przemdiot_zgloszenia\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"przemdiot_zgloszenia\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"corruption\">corruption<\/option><option value=\"public procurement\">public procurement<\/option><option value=\"financial services, products and markets\">financial services, products and markets<\/option><option value=\"anti-money laundering and counter-terrorist financing\">anti-money laundering and counter-terrorist financing<\/option><option value=\"product safety and compliance\">product safety and compliance<\/option><option value=\"transport safety\">transport safety<\/option><option value=\"environmental protection\">environmental protection<\/option><option value=\"radiological protection and nuclear safety\">radiological protection and nuclear safety<\/option><option value=\"food and feed safety\">food and feed safety<\/option><option value=\"animal health and welfare\">animal health and welfare<\/option><option value=\"public health\">public health<\/option><option value=\"consumer protection\">consumer protection<\/option><option value=\"privacy and personal data protection\">privacy and personal data protection<\/option><option value=\"network and information systems security\">network and information systems security<\/option><option value=\"financial interests of the State Treasury of the Republic of Poland, local government units, and the European Union\">financial interests of the State Treasury of the Republic of Poland, local government units, and the European Union<\/option><option value=\"the EU internal market, including public-law rules on competition and state aid, and taxation of legal persons\">the EU internal market, including public-law rules on competition and state aid, and taxation of legal persons<\/option><option value=\"constitutional freedoms and rights of the individual and citizen \u2014 occurring in relation to public authorities and not connected with the areas indicated in items 1\u201316\">constitutional freedoms and rights of the individual and citizen \u2014 occurring in relation to public authorities and not connected with the areas indicated in items 1\u201316<\/option><\/select><\/span>\n \n\t\t\t<p class=\"uacf7-buttons\">\n\t\t\t\t<button class=\"uacf7-prev\"\n\t\t\t\t\tdata-form-id=\"15688\">Previous<\/button>\n\t\t\t\t<button class=\"uacf7-next\"\n\t\t\t\t\tdata-form-id=\"15688\">Next<\/button>\n\t\t\t\t<span class=\"wpcf7-spinner uacf7-ajax-loader\"><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t\n\n\t\t<div class=\"uacf7-step uacf7-step-15688 step-content\"\n\t\t\tnext-btn-text=\"Next\" prev-btn-text=\"Previous\">\n\t\t\t\n\n<h4>2. CONTACT DETAILS OF THE PERSON REPORTING A BREACH OF LAW<\/h4>\n<label>Type of Report<\/label>\n<span style=\"font-size:12px;\">\n<strong>Anonymous report<\/strong> <br>If this form of Report is selected, the reporting person will not receive feedback regarding the Report.\n<\/span>\n<br><br>\n<span style=\"font-size:12px;\"><strong>Non-anonymous report<\/strong><br>If this form of Report is selected, the reporting person will receive feedback regarding the Report. The reporter\u2019s data are confidential and will not be disclosed publicly.  <\/span><br><br>\n\n<span class=\"wpcf7-form-control-wrap\" data-name=\"rodzaj_zgloszenia\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"rodzaj_zgloszenia\" value=\"non-anonymous\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">non-anonymous<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"rodzaj_zgloszenia\" value=\"anonymous\" \/><span class=\"wpcf7-list-item-label\">anonymous<\/span><\/label><\/span><\/span><\/span>\n<br><br>\n<div class=\"uacf7_conditional conditional-492\">\n\n<label>First and last name*<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"imie_i_nazwisko_zglaszajacy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"imie_i_nazwisko_zglaszajacy\" \/><\/span>\n\n<label>Phone*<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"telefon_zglaszajacy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"telefon_zglaszajacy\" \/><\/span>\n\n<label>E-mail*<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email_zglaszajacy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email_zglaszajacy\" \/><\/span>\n\n<label>Correspondence address<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"adres_korespond\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adres_korespond\" \/><\/span>\n\n<\/div>\n\t\t\t<p class=\"uacf7-buttons\">\n\t\t\t\t<button class=\"uacf7-prev\"\n\t\t\t\t\tdata-form-id=\"15688\">Previous<\/button>\n\t\t\t\t<button class=\"uacf7-next\"\n\t\t\t\t\tdata-form-id=\"15688\">Next<\/button>\n\t\t\t\t<span class=\"wpcf7-spinner uacf7-ajax-loader\"><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t\n\n\n\t\t<div class=\"uacf7-step uacf7-step-15688 step-content\"\n\t\t\tnext-btn-text=\"Next\" prev-btn-text=\"Previous\">\n\t\t\t\n<h4>3. INFORMATION ABOUT THE REPORT OF A BREACH OF LAW<\/h4>\n\n<label>Date of the incident subject to the Report<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"data_zgloszenia\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"data_zgloszenia\" \/><\/span>\n\n<label>Date when the information about the incident subject to the Report was obtained<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"data_informacji_zgloszenia\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"data_informacji_zgloszenia\" \/><\/span>\n\n<label>Place where the incident subject to the Report occurred<\/label>\n<span style=\"font-size:12px;\">Enter the exact location of the Incident \u2014 address, room, name of the Organizational Unit<\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"miejsce_zgloszenia\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"miejsce_zgloszenia\" \/><\/span> \n\n<label><strong>Potential witnesses of the Report<\/strong><\/label>\n<span style=\"font-size:12px;\">Enter the names of potential witnesses of the incident; if there were none, enter \u201cNo witnesses\u201d<\/span>\n<label>First and last name<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"imie_nazwisko_swiadek\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"imie_nazwisko_swiadek\" \/><\/span>\n\n\t\t\t<p class=\"uacf7-buttons\">\n\t\t\t\t<button class=\"uacf7-prev\"\n\t\t\t\t\tdata-form-id=\"15688\">Previous<\/button>\n\t\t\t\t<button class=\"uacf7-next\"\n\t\t\t\t\tdata-form-id=\"15688\">Next<\/button>\n\t\t\t\t<span class=\"wpcf7-spinner uacf7-ajax-loader\"><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t\n\n\t\t<div class=\"uacf7-step uacf7-step-15688 step-content\"\n\t\t\tnext-btn-text=\"Next\" prev-btn-text=\"Previous\">\n\t\t\t\n\n<label>Description of the Report<\/label>\n<span style=\"font-size:12px;\">A detailed description of the Report, including the persons involved, the place, and the circumstances of the Report<\/span><br><span class=\"wpcf7-form-control-wrap\" data-name=\"opis_zgloszenia\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"opis_zgloszenia\"><\/textarea><\/span>\n\n\n<h4>4. EVIDENCE CONCERNING THE REPORT<\/h4>\n<span style=\"font-size:12px;\">Enter the name and type of evidence confirming the breach. Describe the circumstances in which the evidence was obtained and attach supporting documentation, e.g., photos, videos, audio files, e-mails, screenshots, notes, text messages, or other documents. <\/span><br><br>\t\n<label>Do you have evidence concerning the Report?<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-343\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-343\" value=\"yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-343\" value=\"no\" \/><span class=\"wpcf7-list-item-label\">no<\/span><\/label><\/span><\/span><\/span>\n<div class=\"uacf7_conditional conditional-702\">\t\t\t\n<div class=\"uacf7_repeater\" repeat=\"\" uacf7-repeater-id=\"uarepeater-507\"><div class=\"uacf7_repeater_sub_fields\"><div class=\"uacf7_repeater_sub_field\">\n<label>Name\/type of evidence<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nazwa_dowodu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nazwa_dowodu\" \/><\/span>\n<label>Information about the evidence<\/label>\n<span style=\"font-size:12px;'\">Indicate information about the attached evidence (what it shows \/ what the evidence concerns, date of obtaining the evidence, etc.) <\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"okolicznosc_dowodu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"okolicznosc_dowodu\" \/><\/span>\n<button type=\"button\" class=\"uacf7_repeater_remove\">Remove evidence<\/button><\/div><\/div><div class=\"uacf7_repeater_controls\"><input type=\"hidden\" class=\"uacf7-repeater-count\" name=\"uarepeater-507_count\" value=\"\"><span class=\"uacf7_repeater_button_wraper\"><button type=\"button\" class=\"uacf7_repeater_add\">Add another evidence item<\/button><\/span><\/div><\/div>\n<br><br><h4>5. ATTACHMENTS CONCERNING THE REPORT<\/h4>\n<span style=\"font-size:12px;\">Attach photos, documents, video recordings<\/span>                                                                                                                                                                                                                                                                                                   \t\t\n<div class=\"uacf7_repeater\" repeat=\"\" uacf7-repeater-id=\"uarepeater-490\"><div class=\"uacf7_repeater_sub_fields\"><div class=\"uacf7_repeater_sub_field\">\n<label>Attachment<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zalcznik_nazwa1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zalcznik_nazwa1\" \/><\/span>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"file-767\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpeg,.png,.wav,.mp3,.mp4\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"file-767\" \/><\/span>\n<button type=\"button\" class=\"uacf7_repeater_remove\">Remove attachment<\/button><\/div><\/div><div class=\"uacf7_repeater_controls\"><input type=\"hidden\" class=\"uacf7-repeater-count\" name=\"uarepeater-490_count\" value=\"\"><span class=\"uacf7_repeater_button_wraper\"><button type=\"button\" class=\"uacf7_repeater_add\">Add attachment<\/button><\/span><\/div><\/div>\n<\/div>\n\t\t\t<p class=\"uacf7-buttons\">\n\t\t\t\t<button class=\"uacf7-prev\"\n\t\t\t\t\tdata-form-id=\"15688\">Previous<\/button>\n\t\t\t\t<button class=\"uacf7-next\"\n\t\t\t\t\tdata-form-id=\"15688\">Next<\/button>\n\t\t\t\t<span class=\"wpcf7-spinner uacf7-ajax-loader\"><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t\n\t\t<div class=\"uacf7-step uacf7-step-15688 step-content\"\n\t\t\tnext-btn-text=\"Next\" prev-btn-text=\"Previous\">\n\t\t\t\n\n<h4>6. NOTICES<\/h4>\n<label><strong>LIABILITY<\/strong><\/label>\n<div style=\"text-align: justify\"><span>Pursuant to Art. 57 of the Act of 14 June 2024 on the protection of whistleblowers (Journal of Laws 2024, item 928, as amended), anyone who submits a Report or makes a Public Disclosure knowing that no breach of law has occurred is subject to a fine, restriction of liberty, or imprisonment for up to 2 years. Other criminal provisions regarding reporting and disclosure of identity are set out in Articles 54 to 59 in Chapter 6 \u201cCriminal provisions\u201d of the Act of 14 June on the protection of whistleblowers (Journal of Laws 2024, item 928, as amended). Other provisions regarding liability are set out in Articles 16 to 17 in the chapter \u201cProhibition of retaliatory actions and protective measures\u201d of the Act of 14 June on the protection of whistleblowers (Journal of Laws 2024, item 928, as amended), which indicate information on the grounds for and exclusions from liability.     <\/span><\/div>\n<br><br><label><strong>COMPENSATION<\/strong><\/label>\n<div style=\"text-align: justify\"><span>Pursuant to Art. 15. of the Act of 14 June 2024 on the protection of whistleblowers (Journal of Laws 2024, item 928, as amended), a person who has suffered damage due to a knowingly false Report or Public Disclosure by a Whistleblower has the right to compensation or redress for infringement of personal rights from the Whistleblower who made such a Report or Public Disclosure. Pursuant to Art. 14 of the Act of 14 June 2024 on the protection of whistleblowers (Journal of Laws 2024, item 928, as amended), a Whistleblower who has been subjected to retaliatory actions has the right to compensation in an amount not lower than the average monthly remuneration in the national economy in the previous year, announced for pension purposes in the Official Gazette of the Republic of Poland \u201cMonitor Polski\u201d by the President of the Central Statistical Office, or the right to redress.    <\/span><\/div><br>\n<h4>PROCESSING OF PERSONAL DATA<\/h4>\n\n<label>Information clause for the person submitting the Report<\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-3\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-3\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\"><div style=\"text-align: justify\"><span style=\"font-size:12px;\">\nPursuant to Art. 13(1) and (2) of Regulation (EU) 2016\/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95\/46\/EC (hereinafter: the \u201cGeneral Data Protection Regulation\u201d; \u201cGDPR\u201d), we inform you that: PPF HASCO-LEK S.A., with its registered office in Wroc\u0142aw, ul. \u017bmigrodzka 242 E, registered in the District Court for Wroc\u0142aw-Fabryczna, 6th Commercial Division of the National Court Register under KRS no. 0000020657, share capital PLN 329,944,036.00 \u2013 fully paid, NIP 895-17-29-489, REGON 932249169, BDO 000037234, is the personal data Controller (hereinafter: the Controller). The Controller has appointed a Data Protection Officer, who can be contacted in matters related to personal data protection at the following e-mail address: iod@hasco-lek.pl. The personal data of the person submitting the Report are processed for purposes related to conducting explanatory proceedings in connection with reported cases of breaches of law. The legal basis for the Controller\u2019s processing of the personal data of the person submitting the Report for the purposes indicated above is: (a) compliance with legal obligations (pursuant to Art. 6(1)(c) GDPR) incumbent on the Controller under applicable law; (b) the Controller\u2019s legitimate interest (pursuant to Art. 6(1)(f) GDPR), which is the defense against claims and the pursuit of its rights; (c) the establishment, exercise and defense of claims (pursuant to Art. 9(2)(f) GDPR). The personal data of the person submitting the Report may be disclosed by the Controller to authorized entities, if necessary in connection with the verification of the Internal Report, in the manner provided for by peremptory provisions of law. Personal data and other information in the Internal Reports Register are stored for 3 years after the end of the calendar year in which Follow-up Actions were completed or after the completion of proceedings initiated by those actions. Providing personal data by the person submitting the Report is voluntary but necessary to receive feedback on the actions taken by the Controller. The person submitting the Report has rights related to the processing of personal data: (a) the right to access their data; (b) the right to rectify personal data; (c) the right to erase personal data or restrict processing; (d) the right to data portability; (e) the right to object \u2014 an objection may be submitted due to a particular situation to the e-mail address: iod@hasco-lek.pl or to the Controller\u2019s address with the note \u201cData Protection Officer\u201d. The person submitting the Report has the right to lodge a complaint with the President of the Personal Data Protection Office. The personal data of the person submitting the Report will not be transferred to a third country or an international organization.<\/div><\/span><\/span><\/label><\/span><\/span><\/span>\n\n\t\t\t<p class=\"uacf7-buttons\">\n\t\t\t\t<button class=\"uacf7-prev\"\n\t\t\t\t\tdata-form-id=\"15688\">Previous<\/button>\n\t\t\t\t<button class=\"uacf7-next\"\n\t\t\t\t\tdata-form-id=\"15688\">Next<\/button>\n\t\t\t\t<span class=\"wpcf7-spinner uacf7-ajax-loader\"><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t\n\n\t\t<div class=\"uacf7-step uacf7-step-15688 step-content\"\n\t\t\tnext-btn-text=\"Next\" prev-btn-text=\"Previous\">\n\t\t\t\n\n<h4>7. DECLARATIONS OF THE PERSON SUBMITTING THE REPORT<\/h4>\n<label><strong>Liability for providing false information<\/strong><\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-1\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-1\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I declare that I submit the Report voluntarily and that I am aware of the liability for making false statements.<\/span><\/label><\/span><\/span><\/span>\n<br><br><label><strong>Good faith<\/strong><\/label>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-2\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-2\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I declare that I am making the Report of a Breach of Law, being an act or omission contrary to the law or intended to circumvent the law, in good faith.<\/span><\/label><\/span><\/span><\/span>\n\n\n\n\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit the report\" \/>\n\n\t\t\t<p class=\"uacf7-buttons\">\n\t\t\t\t<button class=\"uacf7-prev\"\n\t\t\t\t\tdata-form-id=\"15688\">Previous<\/button>\n\t\t\t\t<button class=\"uacf7-next\"\n\t\t\t\t\tdata-form-id=\"15688\">Next<\/button>\n\t\t\t\t<span class=\"wpcf7-spinner uacf7-ajax-loader\"><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<\/div><\/div>\t\t<\/div>\n\t<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Report Form (RF)<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-15689","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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