Motivation

What type of incident are you reporting?

Please select the type of incident

Disability

Race

Religion or belief

Sex or gender

Sexual orientation

Transgender

Other

If 'Other', please specify the personal characteristic that has been targeted

Victim/Witness

Are you

Victim

Witness

Other

Third party reporting centre

If 'Other', please specify

Please provide the name of the centre

The incident

Describe the incident in your own words

Give as much detail as possible eg threats, assault, damage, abusive language used

Please explain why you feel this has been motivated by hatred or prejudice

On what date did the incident happen?

Day

Month

Year

What time did the incident happen?

Hours (HH)

Minutes (MM)

Where did the incident happen?

Search Location

Find Location

Use my current location

Injury/Damage

Was the victim or anyone else injured (optional)

Please select if anyone was injured

Yes

No

Unsure

Please provide details

Did any loss or damage to property result from this incident? (optional)

Please select if any loss or damage occured

Yes

No

Unsure

Please provide more information