Anonymous Sexual Assault Report

Assault Information

Date of Assault Time

Place of Occurrence
An address is preferred, but if it occurred at the victim's home, a team area, part of town or street, coordinates are acceptable.


Suspect Information

Name/Nickname Age

Address

Physical Description/Distinguishing Characteristics
Include odors, scars, tattoos, facial hair, speech impediments, etc.


Suspect/Victim Relationship

Partner/Lover
Ex-Partner/Lover
Spouse
Colleague/Co-Worker
Acquaintance
Met Same Day-Socially
Met Same Day-NonSocially
Stranger

Type of Coercion/Force

Verbal   Physical   Threat of Death     Other Coercion/Force

Presence of a Weapon? Yes No   If yes, what type

Incapacitated by Drugs or Alcohol? Yes No     If yes, what type

Were you physically injured? Yes No
If yes, please describe the extent and nature of your injuries in detail.



Nature of the Assault

Attempted
Completed
Vaginal
Oral
Anal

Place of Occurrence

Victim's Home
Suspect's Home
Unknown Home
Hike/Bike Trail
Car/Vehicle
Workplace
Park
Outdoors
Parking Lot
Other

Manner of initial contact

(Came to victim's door, attacked on street, etc.)


What did the suspect say before, during and after the assault?

Please be as specific as possible


Please give a narrative of the sexual assault

Please provide as much detailed information as possible

Do you plan to make a formal report to the police?

Yes   No   Not Sure

If not yes, why have you chosen to make an anonymous report rather than make a formal report to the police?