Report and speak to an Adviser

This report will remain confidential and the information contained in it will only be passed on to relevant and specially trained staff members on a strictly need to know basis. We will not disclose any personal or identifiable details to others unless we believe that there is a genuine threat to a person’s health and safety.

By reporting through this option you are indicating that you would like a response. This form also gives you the option to request a meeting with a Wellbeing Adviser about the support available to you. If you would prefer not to provide information using this method you can fill in an anonymous report. For more information please see the support tab on the home page.

Please call 999 if you are reporting a crime that is in progress or if someone is in immediate danger.

Are you reporting on behalf of yourself or somebody else?



Where did this happen?


Place of Residence

In Community

What do you think was the reason for this incident?

Where did this happen?

When did it happen? (date and time)

What happened (describe the event or incident)

What was the impact of the event or incident on you or others.

Anonymised Demographic Data - We’ll use this to monitor, analyse and improve our support.

Was this the gender that you were assigned at birth?

What do you want to happen as a result of making this report?

Contact Details


(if applicable):



Additional information – please let us know if there is anything else that you would like to say:

Submit and Confirm

Use of Information

By submitting this report, you agree to the processing of your personal information to:

  • Contact you and arrange an appointment that will discuss your options and identify any support you need.
  • Monitor, analyse and improve support and provision


The University of Huddersfield will maintain confidentiality of the information provided.

There are some exceptions when we may need to share information without your consent if:

  • There is a risk to you or another person
  • There is a concern regarding the safeguarding of children and vulnerable adults
  • The information may lead to the apprehension and prosecution of offenders
  • The information relates to safeguarding national security

Formal Complaints

Submission of this form does not automatically instigate the:

  1. University’s formal complaints procedure.
  2. Reporting or sharing information with the Police or other public authority

Your Adviser will discuss your options related formal processes and support you in the choices you make.