AAPI Hate Incident Reporting Form
Hate incidents include any acts of hostility or violence, physical or verbal, motivated by bias against race or ethnicity, national origin, religion, gender identity, sexuality, or disability. One example of bias would be assuming that an AAPI individual is infected with COVID-19, or that person’s ethnic group is responsible for creating or spreading COVID-19. Even if you are not 100% sure that the incident you experienced was motivated by one of these biases, you should still file a report.

Filing a report with OCA-Asian Pacific American Advocates will help advocacy organizations nationwide fight for the civil rights of all AAPIs. There is no obligation for you to disclose your name, gender, ethnicity, or contact information. If you do not want to disclose this information, please state “Anonymous” or “N/A” when appropriate.

You are not required to file a report with any law enforcement agency. However, OCA encourages you to report to law enforcement independently, if possible.
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Location of Incident
Where did this happen?
State/U.S. Territory: *
City: *
Where did this happen? *
Incident Description
What happened?
What kind of incident are you reporting? *
Required
Date of incident: *
MM
/
DD
/
YYYY
Please describe the incident: *
Please describe the location, context, etc.
Please describe the perpetrator, if possible:
Including gender, race, ethnicity, age, other details.
Have you reported this incident to local authorities? *
If you shared media with us, please add a description of what you uploaded. If Trigger Warning/Content Warning is applicable, please let us know. *
Personal Information
If you'd like, you can leave your name and email address. If you do leave your email, we will check up on you within 1-2 business days.
First name
Last name
Email address
Race *
Ethnicity *
Age
Gender
Sexual Orientation
This information goes directly to OCA National. Do you want us to also share your story with your local OCA Chapter and other advocacy organizations (we will remove your name and identifying information)? *
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