Have you experienced any form of violation, or do you know anyone who has? Report your violation. Your information is completely protected.
DateTime
LayoutLocation of the incident (specific city and area of the city) *Is the incident still ongoing or already in the past? *Please select oneYesNoWhat type of incident are you experiencing? *Please describe the type of rights violation(s) and or abuse(s) you experienced (e.g., harassment, discrimination, violence, unlawful arrest etc.) Description of the Incident *Please provide a brief description of the rights violation(s) and or abuse(s) you experienced (What happened? Who was involved? Were there any witnesses?):Provide Evidences
Do you have any evidence or documentation of the rights violation(s) and or abuse(s)? *Please select oneYesNo (e.g., photos, videos, messages, witnesses or medical documents)? Describe the evidence you have *Would you like to take legal action, or use this as a way to advocate for the rights of LGBTQI persons? *Please select oneYes, I want to take legal action.No, I prefer you anonymously use my documentation to advocate for the rights of LGBTQI persons.
LayoutName of person reporting the incident *Reporter’s phone number: *Survivor's Gender Identity *Trans WomanTrans ManCis WomanCis ManNon-BinaryOtherAge *Name of the Survivor * Reporter’s e-mail address: (optional)Survivor’s sexual orientation *LesbianGayBisexualPansexualAsexuaQueerHeterosexualOccupation *
Are there anything else you would like us to know about the incident? Submit Report
