Hate Incident Reporting

Victim Services Bruce Grey

Serving Bruce & Grey Counties

You can use this form to report a hate-related incident in Bruce or Grey County.

This form does not automatically contact police.
You may report anonymously.
We will only contact you if you ask us to.

If you are in immediate danger, call 911.

Anonymous Reporting

Hate-Motivated Incident Reporting

Where did this happen?

Bruce County Grey County Not Sure

Are you safe right now?

Yes No Not Sure

What happened?

When did this happen?

Today or recently Within the past month More than a month ago It is still happening Not sure

Where did it happen?

At home At work or school In a public place Online Other

What kind of behaviour happened?

Hurtful words Threats Physical harm Damage to property Online harassment Not sure Other

Do you think this happened because of who you are?

Yes No Not Sure

Did you report this to Police?

Yes No Prefer not to say

If you reported the incident, which Police Service did you contact?

Grey Bruce OPP South Bruce OPP Saugeen Shores Police Owen Sound Police Hanover Police West Grey Police Neyaashiinigmiing Police Another Police Service Not Sure

Would you like help talking to Police?

Yes No Not Now

Would you like us to contact you?

Yes No Maybe later

If you do want contact, what are the safest ways to contact you?

Phone Text Email Do NOT leave a message Other

If you do want contact, is there anything we should know to contact you safely?

If you wish to share, what is your name?

If you wish to share, what is your phone number?

If you wish to share, what is your email address?

I understand this report willl be reviewed by Victim Services Bruce Grey staff.

I understand

I understand this form does NOT automatically contact Police.

I understand

If you would like to learn more about how you can support Victim Services Bruce Grey and make a difference in the lives of victims and survivors in our community, please click on the links below.

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