BiasHELP tracks hate crimes and bias-related incidents that occur throughout the United States. This helps us to better understand these incidents and effectively design programs to assist victims and prevent hate crimes from occurring.

Complete this form if:

  • You have been the victim of hate-related harassment, property damage or violence.
  • You have personal knowledge of hate-related harassment, property damage or violence.
*REQUIRED* You are:
If other, please specify
:

You may remain anonymous and do not have to give us any information that would reveal your identity. If, however, you would like more information about hate crimes or require our assistance in some way, please complete the following so we can contact you:

The information you send to YouthWEB is STRICTLY CONFIDENTIAL
and will not be shared with anyone else.

This information is not required unless you want us to contact you.
Your Name:
State:
City:
Phone Number:
e-mail:
INFORMATION ABOUT THE INCIDENT
*REQUIRED* Date of incident:   
*REQUIRED* Location:
If other, please specify:

*REQUIRED* Nature of the incident:

 

Please tell us more about the victim, or if you are
the victim, please tell us more about yourself.
Victim's age City State:
Gender Identity:

Sexual Orientation   Race:   

 If other race, please specify:

Did the victim suffer physical injuries?
If yes, please describe:

*REQUIRED* was the main motivation:

Racial
If other racial, please specify

Ethnicity/National Origin:
If other ethnicity or national origin, please specify:

Religious:
If other religious, please specify:

Sexual:
If other sexual, please specify

Disability:
If other disability, please specify:

*REQUIRED* Was the offender acting alone or part of a group?
Alone Group Unsure

*REQUIRED* Please tell us in your own words what happened?

Was this incident reported to anyone? Yes     No

If yes, please select who:

If the incident was reported to another person
or party, please specify who:

This website is monitored periodically during weekdays. While we may be able to provide you with information, referrals and assistance, we cannot guarantee you an IMMEDIATE response, though we do promise to get back to you as quickly as possible.

Would you like us to contact you about this incident?
Yes     No

If you request to be contacted, please make sure
your contact info is completed
*HERE on this form*

To send this report, please click the submit button below.