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Online Report Form

Report any LGBT hate crime you have experienced or witnessed here. You may remain anonymous and your details will not be passed to the police unless you wish them to be.

You may fill in the online form below or download a PDF copy to print out and send back to us if you prefer.

  1. (required)
SECTION ONE - THE INCIDENT
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  3. (required)
  7. (required)
SECTION TWO - ABOUT THE PERPETRATOR
  1. It helps us to monitor hate crime if you can give as much detail as possible in this section although you do not have to if you do not wish to.
SECTION THREE - ABOUT THE VICTIM
  1. In order to help us deal with hate crime it is useful for us to know some details about you (or the victim if this is not you).
  2. (required)
  3. (required)
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  5. (required)
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  7. (required)
  9. (required)
  10. (required)
  11. (required)
  12. What is the nature of your disability or health problem? (select up to three)


SECTION FOUR - REPORTING ELSEWHERE
SECTION FIVE - WHAT HAPPENS NEXT?
  1. The information you have provided will be anonymously logged by Galop to produce statistics that, where relevant, will be shared with other agencies to help prevent other incidents in the future.
  2. However, if you want the police to investigate the incident, they will need to speak with you
  3. Please select one of the following options:
  5. If you would like to be contacted by a Galop caseworker, or if you want the police to investigate the incident, please provide your contact details below:
  11. (valid email required)
  14. If you have completed as much information as you can, please complete the anti-spam field and click the 'Submit' button below once. You will see a success notice below the form if your form has been accepted
  15. Captcha
 

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