COVID-19 Racism in Canada Incident Reporting
In Canada, xenophobia and racism toward Chinese and other Asian communities have been on a rapid rise since the outbreak of the COVID19.
To confront that racism we need to make our voices and experiences heard. If you have faced discrimination violence and racism as a result of COVID19 please considering filling out this form so that we have a record of you experience.
This is a national project in partnership with several other organizations. We welcome submissions from across Canada.
Individual information, including personal identification details, will be kept confidential. We will not share your identifying information without your permission. We will use the collected experiences to better support our anti-racism advocacy work, and to communicate the shared concerns of discrimination held by Chinese Canadian and other Asian Canadian communities in relation to the pandemic.
Please complete the form for EACH SINGLE incident that you have encountered.
This project is funded by the Department of Canadian Heritage, Government of Canada.
1. Did this incident happen to you or were you a witness?
It happened to me.
I witnessed this incident.
If this did not happen to you, please complete the following questions to the best of your knowledge of the individual who experienced the incident of racism and discrimination.
Child & Adolescent (Under 18)
Young Adult (19-35)
Middle-Aged Adult (36 - 55)
Older Adult (55+)
Prefer not to say
4. Province or Territory
Prince Edward Island
Newfoundland and Labrador
5. City or Town
6. What racial group, or racial groups, do you feel you belong to? (Check all that apply)
White (European, Caucasian, etc.)
Black (African, Carribean, etc.)
East Asian (Chinese, Korean, Japanese, etc.)
Southeast Asian (Vietnamese, Cambodian, Filipino, Laotian, etc.)
South Asian (Indian, Pakistani, Tamil, Sri Lanakan, etc.)
Latino (Hispanic, Latin America, etc.)
Indigenous Peoples (First Nations, Métis, Inuit, etc.)
Middle Eastern (West Asian, Persian, Arab, etc.)
Biracial or mixed
Prefer not to say
7. Date of Incident
8. Time of Incident
Morning (6am - 12pm)
Afternoon (12pm - 5pm)
Evening (5pm - 9pm)
Night (9pm - 6am)
9. Where did the incident occur?
Public space park/street/sidewalk
Business: grocery or food store, restaurant
Business: other stores or offices
10. Location of Incident (e.g. address, main streets and intersection, etc.)
11. Type of Discrimination (Check all that apply)
Verbal harassment/name calling
Coughed at/spat upon
Barred from establishment, or asked to leave (e.g. restaurants, shops)
Barred from transportation, or asked to leave (e.g. Lyft, Uber, public transportation)
Abuse of power by police or police brutality
Abuse of power by authorities (e.g. government employees)
12. Suspected Reason for COVID-19 Discrimination (Check all that apply)
Face mask or clothing
13. Description of Incident (Please provide 2-3 sentences describing the incident)
14. What injury, harm or other impact resulted from the incident? (Check all that apply)
Mental distress/emotional harm
Loss of services and/or benefits to meet my needs
Loss of job
Loss of housing
15. Did you report this incident to: police, human rights commission, management of the company, government, politicians, media, etc.? (Check all that apply). If none of the options apply, please explain in "Other."
No, I did not want to.
No, I did not know how to.
No, I am not so good at English to report.
Yes, to the police.
Yes, to the human rights commission.
Yes, to management of company.
Yes, to a politician.
Yes, to the government.
Yes, to media.
16. Has this incident been reported to the media or posted on social media?
Yes. If available, please provide link in the following question.
17. If you answered yes to the above question, please provide links, photos, news clips, social media posts, etc. of the incident. For photos or attachments, if you are willing, please email them to us at
18. What result would you like to see from sharing your experience? (Check all that apply)
Apology from the offending person(s), business or entity
Consequences for the offending person(s), businesses or entities
19. Do you consent to our organization contacting you based on what you have shared? (Note: This is just permission to contact you. This is NOT permission to publicize your identity)
20. Your name
21. Your email address
22. How did you find out about this online reporting web page?
CCNCTO social media (i.e. Facebook, Twitter, Instagram, Wechat)
PROTECH resource hub website
Social service/community service organization
Friends, family or colleagues
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