Your details
Surname?
Date of birth?
Gender?
Contact details
if we need to contact you about this report, how would you prefer we do that?
Is there anything we need to know about contacting you?
Do you need an interpreter or translator or have any other communication needs?
Your role
How were you involved in what happened?
First name?
Surname?
Is the victim under 18 years of age?
Please give us an estimate of their age?
Gender?
Please describe them
What is your relationship to them?
Would you like to be contacted by a victim and witness support charity that may be able to offer you help and advice?
Do they have a disability?
What’s their ethnic group?
Contact information
Phone number?
Postcode?
Incident details
When did the incident happen?
What time did the incident happen?
Address
Map url
You gave us this map location earlier. Is the address correct?
About the incident
is the incident you’re reporting about one of the following
Choose from list
Why do you think this was motivated by hatred?
Injuries
were you or anyone else injured in the incident?
Loss or damage to property
Did any loss or damage to property result from this incident?
Witnesses:
List each witness details
Were there any witnesses?
Witness 1
First name
Surname
Phone number
Gender
Description
Suspects
How many suspects were there?
Do you know them?
Suspect 1
Description: what did they look like?
Age
Ethnicity
Do you have any more information about them?
Did the suspect(s) have a vehicle?
You can also report the incidents anonymously,