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Reporting a hate crime
Please use this form to record a hate crime, please do not put any names of who was involved, apart from your own name.
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* Indicates required question
What is your name? You must leave your name so this can be followed through by the police, and New Directions can support you.
Your answer
Date of hate crime
*
MM
/
DD
/
YYYY
Time of hate crime (or as close to)
Time
:
AM
PM
What was said?
*
Your answer
What did they do?
*
Your answer
Do you know why they did it?
*
Yes
No
Don't know
If yes, why did they do it?
Your answer
Where did the hate crime happen?
*
Your answer
Were you injured
Yes
No
Clear selection
If yes, please detail the injuries
Your answer
Was there any damage to property?
Yes
No
Maybe
Clear selection
If yes please give detail
Your answer
Please confirm if there were an witnesses
Yes
No
Don't know
How are you feeling? Is there any support you feel you need?
Your answer
Do you want this reporting to the police? By selecting yes, you give New Directions the permission to support you to report this.
*
Yes
No
Submit
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