Safe Sanctuary Initiative Reporting Form

Safe Sanctuary Initiative Reporting Form

This form is for individuals to confidentially report criminal or unethical activity occurring within church organizations, ministries, or leadership. All submissions are reviewed and handled discreetly to protect your privacy.
Section 1: Reporter Information

Optional - You may remain anonymous
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Would You Like To Remain Anonymous?

YesNo
Section 2: Church/Organization Information
Name Of Church/Organization:
Location (Address, City, State):
Pastor/Leader Name (if known):
Church Website or Social Media (if available):
Section 3: Incident Details
Date Of Incedent

MonthDayYear
Date
Type Of Incident:

Financial MisconductSexual Misconduct Or AbusePhysical AbuseEmotional or Spiritual AbuseCorruption or FraudNegligence or Cover-UpOther
If Other, Please Describe:
Describe in detail what occurred(Include names, actions, dates, and any other relevant information):
Section 4: Evidence or Supporting Information
Do you have documentation, photos, messages, or recordings related to the incident?

YesNo
If yes, upload files below!
File Upload

Cancelof
Are there any witnesses or other victims? Please list names or details if known:
Section 5: Desired Outcome
What outcome(s) are you seeking from this report?

InvestigationLegal Action Or ReferralChurch Accountability Or ClosureSupport/Protection for VictimsOther
If Other, Please Describe:
Section 6: Acknowledgment & Consent
By submitting this form, I affirm that the information provided is accurate to the best of my knowledge. I understand that the Safe Sanctuary Initiative will review this report and may contact me (if I provided contact information) for clarification or follow-up.

I acknowledge and consent to the terms above.
Signature
Should be Empty:

Safe Sanctuary Initiative Reporting Form

Section 1: Reporter Information

Section 2: Church/Organization Information

Section 3: Incident Details

Section 4: Evidence or Supporting Information

If yes, upload files below!

Section 5: Desired Outcome

Section 6: Acknowledgment & Consent