Prejudice & Discrimination Reporting Form
If this form is not loading properly, please click here: http://grec.co.uk/prejudice-discrimination-reporting-form/ or alternatively phone GREC on 01224 595505

This is an online form for reporting Prejudice Incidents and Discrimination in Aberdeen. These are incidents where someone has been treated unfairly, abused, bullied, harassed, or assaulted (etc.), because of what is called a "protected characteristic" (see question 2 for some examples). Click here (https://goo.gl/K28cqA) for instructions and further information. If you would like support to complete this form please phone Grampian Regional Equality Council on 01224 595505 between 10am-4pm, Monday to Friday.

Please note that this form is confidential and your details will not be shared unless you ask us to do so.

Kliknij tutaj po polską wersję językową: https://goo.gl/1a0qRa (Polish Form)
Pentru versiunea ȋn limba româna, click aici: https://goo.gl/A7WupM (Romanian Form)
Для русской версии нажмите здесь: https://goo.gl/Es11qk (Russian Form)

1. Are you:
2. Which of the following do you think the incident relates to?
Required
3a) At what location did the incident happen (e.g. playground, café)?
Your answer
3b) In what area did the incident happen (e.g. City Centre)?
Your answer
4a) When did the incident happen?
MM
/
DD
/
YYYY
4b) What time did the incident happen (approximately)?
Time
:
5) Please tell us what happened:
Your answer
6a) What do you want to happen now?
6b) If you would like Grampian Regional Equality Council to contact you (or the person targeted) to discuss further support and action, please provide your name, an email address and/or phone number:
Your answer
7) Details of the person targeted (if known)
7a) Age:
Your answer
7b) Gender:
7c) Ethnic group or background:
If "other", please specify
Your answer
7d) Religion/belief:
If "other", please specify
Your answer
7e) Does the person targeted have a disability?
7f) Sexual orientation:
If "other", please specify
Your answer
8) Perpetrator Details (if known)
If there was more than one perpetrator, please answer the following questions for the individual you know the most information about. You can add any information about other perpetrators at question 9 ("Any other information you would like to add")
8a) Age:
Your answer
8b) Gender:
If "other", please specify
Your answer
8c) Ethnic origin or background?
If "other", please specify
Your answer
8d) Religion/Belief:
If "other", please specify
Your answer
8e) Does the perpetrator have a disability?
8f) Sexual orientation of the perpetrator?
If "other", please specify
Your answer
Any other information
9. Any other information you would like to add:
Your answer
Data Protection
Your personal information will be processed fairly and lawfully and in accordance with the principles of the Data Protection Act 1998. The information you provide will be treated confidentially by GREC and personal data will only be shared with another organisation unless you provide your consent, or there is risk of serious harm to yourself and another person.
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