Section 0

Are you reporting on behalf of yourself or somebody else?

What is your connection with the university?

Section 1

Which of the following best describes the situation your report relates to?

Click on the question marks (?) for more information.


What Date did the Incident Occur?

What time of day did the Incident Occur?

Where did the Incident Occur?

Are you able to provide any more details of the incident(s)?

It may be useful for your adviser to have some contextual information in advance. For example: Are you reporting one or multiple incidents? When did the incident(s) occur, i.e. recently or more than a year before? Where did the incident occur, e.g. online, on campus/off campus, etc? Is the perpetrator known to you? This kind of detail also helps us as an institution to gain a better understanding of the difficulties our staff/students may be facing and informs efforts to create a safer and more supportive environment for all.

Section 2

Do you believe the incident/action was motivated by any of the following?

For reports of sexual violence/harrassment or relationship abuse, select "Not Applicable" and go straight to the next question. If you believe there was more than one motivation, please choose what you believe to be the main motivation and detail other elements in the text box on the next page.

Section 3

Which area of the University are you connected to?

If you are not comfortable identifying your connection to the University, please select "Prefer not to say" at the bottom or select "Other" to provide another option.

School of Applied Sciences

School of Business, Law and Social Sciences

School of Design and Informatics

University Services


Section 4

Please fill in the following information about yourself. We monitor reports by these equality groups to inform our future work. For example, we might want to know how many female students have made a report in the last 6 months. We do not include any personal details in these monitoring reports. If you are not comfortable providing this information, please select "Prefer not to say".



Do you consider yourself to be disabled within the definition of the Equality Act 2010?

The Equality Act 2010 describes a disabled person as: "…anyone who has a physical, sensory or mental impairment, which has a substantial and long term adverse effect on their ability to carry out normal day-to-day activities."






Is your gender identity different from the gender you were assigned at birth?


Religion or belief


Sexual orientation

Section 5

Send Report

By submitting this form, we will use the anonymised information to help make the University a safe place for everyone. Full details of how we use and store your data are set out in our privacy policy.