Social Justice Incident Report Do you want to remain anonymous?YesNoNameEmail AddressPhoneDateDepartment/Institution TypeDepartment/Institution TypePoliceClinic/HospitalHome AffairsMunicipalityType of misconductType of misconductPhysical abuseVerbal abuseCorruption/Bribery,Sexual harassmentDiscriminationDenial of serviceOtherBrief summary of what happenedAttach Supporting EvidenceAccept: .jpg, .png, .pdf, .mp3, .mp4, .docxChoose FileNo file chosenDelete uploaded fileI consent to my report being used for advocacy or analysis *CheckSubmit