Safer community - support form

Safer community - support form

Reporting an incident

If you or someone you know has experienced unwanted or threatening behaviour, or you have witnessed this behaviour, you can submit a Support Request Form to Safer Community - either anonymously or with your contact details.

 

 

Support request form

Page 1 of 7
Begin your report
Page 1 of 8
Begin your report
This form allows you to report a concern or incident to Safer Community. Any information you share will be kept confidential, though if we believe there is a significant risk of harm to yourself or someone else, we may be obligated to disclose information and/or take appropriate actions to protect health and safety.

Please note, if this form is submitted anonymously our capacity to respond or provide support may be limited.
Page 2 of 7
Incident details
Page 2 of 8
Incident details






Page 3 of 7
About you
Page 3 of 6
About you
Page 3 of 7
About you
Page 3 of 8
About you
Page 3 of 7
About you
Page 3 of 8
About you
Note: If you provide your contact details, a member of our team will get in touch with you to respond to your request or concern as soon as possible.  








Acknowledgement of the request lodged is sent to this email and all future communications will also be done to this email
Acknowledgement of the request lodged will not be sent to your mobile however all future communications will be done via this mobile number


Page 4 of 6
Impacted person details
Page 4 of 7
Impacted person details
Page 4 of 6
Impacted person details
Page 4 of 8
Impacted person details







Additional Impacted person(s)







Page 4 of 6
Person of concern details (if known)
Page 5 of 7
Person of concern details (if known)
Page 4 of 7
Person of concern details (if known)
Page 5 of 8
Person of concern details (if known)
Note: This is the person whose behaviour is concerning you.







Additional person(s) of concern







Page 5 of 6
Emergency details
Page 6 of 7
Emergency details
Page 5 of 7
Emergency details
Page 6 of 8
Emergency details


Page 6 of 7
Follow up call?
Page 7 of 8
Follow up call?

Page 8 of 8
Submit your report
Page 6 of 6
Submit your report
Page 7 of 7
Submit your report

We are collecting your personal information on this form for the primary purpose of reviewing and responding to your request, complaint or concern (all referred to as a "concern"). This may include investigation and ongoing management of your concern. We will also use your personal information to provide you with information and support appropriate to your concern. Your personal information may be made available to other RMIT staff members but only to the extent of their need to know it to enable RMIT to respond to your concern. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws.

RMIT will also use the information on this form for internal planning, analysis and quality improvement.

You are not required to provide the personal information requested, however if it is not provided, RMIT may not be able to respond to or investigate your concern or take any further action to action your request or assist you.

For further information on how we manage your personal information, please refer to our RMIT Privacy Statement.

Contact Information

aboriginal flag
torres strait flag

Acknowledgement of Country

RMIT University acknowledges the people of the Woi wurrung and Boon wurrung language groups of the eastern Kulin Nation on whose unceded lands we conduct the business of the University. RMIT University respectfully acknowledges their Ancestors and Elders, past and present. RMIT also acknowledges the Traditional Custodians and their Ancestors of the lands and waters across Australia where we conduct our business - Artwork 'Luwaytini' by Mark Cleaver, Palawa.

More information
aboriginal flag
torres strait flag

Acknowledgement of Country

RMIT University acknowledges the people of the Woi wurrung and Boon wurrung language groups of the eastern Kulin Nation on whose unceded lands we conduct the business of the University. RMIT University respectfully acknowledges their Ancestors and Elders, past and present. RMIT also acknowledges the Traditional Custodians and their Ancestors of the lands and waters across Australia where we conduct our business.

More information