Bias & Hate Incident Report

Amid the growing threat of the corona virus, there are surging reports of xenophobic and racist incidents targeting members of our immigrant communities and others. This reporting form was created to make it easier for individuals to report these incidents, even if they are not legally actionable or a crime.

We are not law-enforcement nor are we a government agency, we are your neighbors, your friend, your support, and your community.

All identifiable personal information reported through this form will be kept strictly confidential. You are not required to provide identifiable personal information unless you would like to be contacted or need assistance.

Stop the Hate Community

Who is making this report? Please select one.
What is the race/ethnicity/national origin of the Target
Specify race/ethnicity/national origin:
What is the gender identity of the Target?
Specify gender Identity
What is the approximate age of the Target?
Who was the Perpetrator?
Perpetrator
This field is hidden when viewing the form
Please provide the approximate location or cross streets of the Incident.
Please provide the approximate location or cross streets of the Incident. **DO NOT LIST PERSONAL ADDRESS**
Street Address If Business please list City State ZIP Code
Please select the type of location.
If at a Business or Workplace
- Customer
- Employee
Please select one
List a location not mentioned above.
What best describes what happened during the Incident? Please select one.
Incident Type.
What day did the Incident occur?
MM slash DD slash YYYY
Approximately what time did the Incident occur? Please select one
Was anyone physically injured in this Incident?
Why do you believe the Perpetrator chose the Target in this Incident? Please select all that apply
List why your were target if not in list above.
Was this Incident reported to the police or other government agency?
Please provide a brief paragraph narrative of the Incident. Please do not provide names or sensitive, private or personal information. Include details not previously reported in this Form.
If you were the Target, have you experienced other hate and bias incidents in the last 12 months?
- No
- Yes
If you were the Target, have you sought support to heal from this experience?
Support
Would you like to be contacted about the incident or do you need assistance?
Contact Information
Name
First Last
Email
Phone
Record a video and upload it here or submit photos of the incident.
Upload a video or photos
Drop files here or

Max. file size: 31 GB.
You can record an incident and upload it here.
Link 1
Link 2
Link 3
Name
This field is for validation purposes and should be left unchanged.

Victims of hate crimes and bias incidents across Washington can speak with a trained advocate 24 hours a day, 7 days a week. Services are available to all people regardless of immigration status. Interpretation services are available.

Washington State Crime Victim Service Center Hotline

1-888-288-9221

www.wacvschotline.org

Stop the Hate Community

Contact Information

Record a video and upload it here or submit photos of the incident.