Report it! online form

Tell us what happened

Please note: this report is NOT a formal complaint. If you want to make a formal complaint of discrimination, tick the box at the end of this form and include your contact details so we can contact you about the incident and whether or not it might be discrimination.

Details of the person making this report

* no spaces (12345678)

Are you the person who was abused or harassed?

eg, friend, family member, community worker, don't know them

Details of person who was abused or harassed

(OPTIONAL- the person can be anonymous)

* no spaces (12345678)

Gender

Age

Is the person

Tell us about what happened

When did it happen (if known)

eg, street, shopping centre, mall, bus stop, shop, service, park, work, school, public transport, sport etc

Did you report the incident?

eg, police, teacher, manager, service provider, other

eg, didn't know I could, too scared, too busy etc

Why do you think it happened? For example, was it because of your:

eg, name/organisation

eg, number plate, address, etc

eg, I don't, co-worker, boss, etc

Do you want us to contact you to talk about this further or explain how to make a discrimination complaint?

(If yes, make sure we have your contact details)

Personal information will be managed in accordance with the Personal Information Protection Act 2004 and may be accessed by the person to whom it relates on request, in writing, to Equal Opportunity Tasmania.