Coronavirus Anti-AAPI Racism Incident Report
In the past several weeks, the world has been hit by what the World Health Organization is calling a “global pandemic.” As the virus Covid-19 spreads, numerous Asian Americans and Pacific Islanders (AAPI) have reported experiencing microaggressions, racial profiling, hate incidents and in some cases, hate violence. In Los Angeles, a child in San Fernando Valley was physically assaulted at his middle school and accused of having the coronavirus simply because he is AAPI. On a San Francisco street, a young AAPI woman was spat upon and blamed for bringing the coronavirus to the U.S. Young people as well as adults and seniors in California fear being perceived as the source or carrier of the disease.

Asian Pacific Policy and Planning Council (A3PCON) and Chinese for Affirmative Action (CAA) have launched this reporting center to allow community members to report incidents of hate they have experienced. Individual information, including personal identification details, will be kept confidential and will only be shared with permission. In the aggregate, the information will be used for assistance, advocacy and education.

We are working to translate this form into additional languages. We ask for your patience as we add them to this site.

Thank you for reporting your incident to A3PCON and CAA.

Submitting the incident to A3PCON and CAA using the form below will enable us and our collaborative partners to monitor incidents in CA and around the country. Your submission will be kept confidential.

Unfortunately, we cannot respond to all submissions. If the matter is urgent, please CALL 911.
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Age
(Optional)
Your answer
Gender
(Optional)
Your answer
Ethnicity *
Your answer
Organizational Affiliation
(Optional)
Your answer
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Site of Discrimination (Click all that apply) *
Required
Location/Address of Incident *
Your answer
Type of Discrimination (Click all that apply) *
Required
Suspected Reason for Covid-19 Discrimination (Click all that apply) *
Required
Description of Incident *
Please provide 2-3 sentences describing the incident.
Your answer
Any Supporting Links
(News Clips, Social Media Sites)
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Asian Pacific Policy and Planning Council. Report Abuse