Meldeformular EN

Incident report form

Introduction

Are you a victim of discrimination, threat, or physical attack on account of your faith?

In case of a serious and imminent threat we urge you to contact your local police or dial 117.

The following questions relate to a situation in which you were discriminated against, threatened, intimidated, or physically attacked. This includes information about the nature of the incident, location of the incident, and information about the perpetrator(s). Please complete the form accordingly. In serious cases, we advise you to also file a report with the police.

You can also fill in this form anonymously. In that case, we cannot help you, but your report will help us to map the extent and seriousness of the problem.

You can also complete a report on behalf of someone else. If you have a friend or acquaintance who was victimized, you may also report this here. However, please consult with the victim about this first.

We ask you to complete the form in your chosen language. If the form is completed in a different language, we are unfortunately unable to process your report and provide follow-up.

Confidentiality and privacy
The information shared with us through this form will be treated confidentially. Personal details received through this report will be used solely for the registration of this report and to contact you in connection to this report as needed. For additional information, please see our privacy statement.

Reporter

Title

Last Name

First Name

Address

Phone number

E-Mail*

* This is the only required field in the form. We require your email address, in order to be able to send you a confirmation and summary of your report.

Relationship to the victim

I am the victim

I am a relative of the victim

I work at a center for immigrants or refugees

I am a friend or acquaintance of the victim

Victim

Personal information of the victim

Permission of the victim

Yes, the victim has given me permission to provide their information to BIR of the Swiss Evangelical Alliance

Title

Last Name

First Name

Address

Canton

Phone number

Country of origin

Ethnic origin

Religious background

Other religious community, namely…

Have you changed your religion? If yes, when?

If yes, what was your religion before?

Other religious community, namely…

Perpetrator

Information about the perpetrator(s)

Name(s) of the perpetrator(s)

Gender

Relationship to the perpetrator(s)

The perpetrator(s) is/are

Country of origin

Ethnic origin

Religious background

Other religious community, namely…

Police

Was this incident reported to the police?

If yes, what steps did the police take? What did the police suggest or advise?

Who reported the incident to the police?

If not, why has the incident not been reported to the police?

Does the victim give us permission to report the incident to the police?

COA

Measures taken at the asylum housing agency / reception center management

Has the incident(s) been reported to the transit center or reception centre management?

If yes, when?

Who was the report filed with?

What response was suggested or initiated? – Please check off all that apply.

No action was taken

Was/were the perpetrator(s) spoken to about their behaviour and cautioned by the center management?

Did the management of the center inform the police?

The perpetrator(s) was/were relocated (internal) to a different room or center?

The perpetrator(s) was/were barred from the center for a specific period of time

The victim was relocated to a different reception center

If “No,” why was the incident not reported to the management of the asylum center?

Does the victim give us permission to report the incident to the management of the agency or asylum center? If "yes", please provide the ID number of the victim.

Submit

Is there anything else you’d like to share as part of your report?

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