FreeState Justice – Community Harm Report

FreeState Justice – Community Harm Report

Use this form to report incidents, harmful experiences, or misinformation that impact LGBTQ people or other vulnerable communities.
Note: This is not a service request form. If you would like to request direct services, please fill out one of these request forms.

Legal Services: https://tinyurl.com/5n8wjw3v

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Name (Optional)

First NameLast Name
Email (Optional)
example@example.com
Phone Number (Optional)
Please enter a valid phone number.
Date/Time
Location (City, Town, or Online)
Brief Description of Community Harm
Who Was Affected:

LGBTQ+ Person(s)YouthOlder AdultPerson of ColorOther
Type of Harm

Discrimination/HarrassmentViolence or ThreatsHate Speech / StigmaDenial of Service (Housing, Job, Healthcare)Threats to Immigrant CommunitiesPolicy / Institutional HarmOther
If you selected other to the previous question, please describe to the best of your ability here:
Have you seen harmful texts, emails, or social posts?

YesNo
If you responded yes to the previous question, please describe it here, or upload an image below:
Upload Here

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Follow Up

Contact MeJust Log This Report
Confidentiality: Reports are kept private and only used to support community safety and advocacy.
Should be Empty: