Please list the date, activity, and total number of hours. Each new record goes on a new line.
Note: The following closed questions will help us collect information that will enable us to keep track of trends and inform our proactive and preventative actions, whether your report is anonymous or with contact details. Keep in mind that there is the “Prefer not to say” option available.
Note: We know that this can be hard but the more information you provide, the more we will be able to help you or others. You can include when, where and what you experienced. Or share if someone else has witnessed the incident. Mention if anyone else was involved. Have you reported this incident to someone else? Have you had prior issues with the person involved? (If yes what kind of prior issues). If you provide names of other individuals, this doesn’t imply that measures or actions will be taken automatically against them. If you have agreed to be contacted by a relevant officer, you will be updated about the actions that we plan to take, and you can decide whether you wish your identity to be revealed or not. If you have chosen to report anonymously or after discussing with the relevant officer you declare that you don’t wish your identity to be revealed, we will protect your anonymity; however, we can use your report to inform our prevention work. Please consider that action may be taken when deciding if you wish to name or include identifiable information about the person/situation you are reporting. You are not required to include this information at this stage, especially if you are filling this report with your contact details and you have agreed to be contacted by a responsible officer.
In checking the box above, you agree and confirm that all community service reports are true and accurate. You acknowledge that your service advisor may reach out to the location to confirm your participation.