Date of incident
Time of Incident
This report is
I don't know
Who did this happen to?
Friend or co-worker
Peer educator making a report on behalf of a peer
If you are making the report on behalf of someone else, do you have their consent?
If this incident happened to you, can you tell us more about yourself? Please give as much or as little detail as you are comfortable with. I work as a:
I work as a cis-gendered woman
I work as a transgender woman
I work as a cis-gendered male
I work as a transgender male worker
I work as a gender fluid or NB worker
None of these fit my work styles
What type of sex work:
Brothel or parlour
Other (please specify)
If this incident happened to you, can you tell us more about yourself? Please give as much or as little detail as you are comfortable with. I work as
Other (please specify)
Tell us as much as you can about the mug- starting with their gender.
Other (please specify
Hair colour, length and style
Any more distinguishing features about the mug? Tattoos, beard, scars
Any other identifying information
How did the mug find you? E.g. advertising platform.
Where did the incident occur? If possible, please state area, address or venue name:
What happened? Please give as much or as little detail as possible: [long answer]
Is this the first time the incident has been reported?
No, this is the first time I have reported it to Vixen
Yes, these are additional details to add to the report
I don’t know
Would you like this incident to be reported to the police?
Yes, I reported the incident.
I am unsure if I want to report. it to the police.
No, I do not want to report it to the police.
Vixen peer educators can talk through reporting options and assist in dealing with police. You can leave your details below and one of our peer educators will be in touch with you.
If you have already reported to the police, which station was it?
If possible, please provide names of officers or any other identifying details such as badge number, appearance, time or date.
How would you describe your interaction with police? Did you feel they took your report seriously?
If applicable, please state which name you are known to police by. If Vixen does not need to know your name, please do not include it