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Sarnia Lambton Alliance Against Hate (SLAH) Reporting Survey

Sarnia Lambton Alliance Against Hate (SLAH) offers support and opportunities for connection to those impacted by acts of hate. SLAH also knows that acts motivated by hate often go unreported, and seeks to collect a more accurate representation of these acts in our community through this tool.

In case of an emergency please call 911. Emergency includes a crime in progress, an immediate threat etc.

Please note that this is not a formal police report and information is not automatically shared with police.

Information from this form is submitted to the Sarnia Lambton Alliance Against Hate. Every effort will be made to respond to request for support within 2 business days. If you require assistance sooner please call the Distress Line Sarnia Lambton at 1-888-DISTRES (347-8737)

If you would prefer to leave a voicemail, SLAH can be reached at 519-336-1020 extension 010. Every effort will be made to respond to voicemails within 2 business days.
This question requires a valid date format of MM/DD/YYYY.
5. Please choose all acts that apply to this incident *This question is required.
6. In your opinion, what is the reason for this incident/discrimination? Please check all that apply whether real or perceived. *This question is required.
8. Was there more then one person targeted?
9. Are you reporting on behalf of yourself or someone else? *This question is required.
10. What is your gender (check all that apply)
10. What is your racial group, ethnicity or nationality? (check all that apply)
10. What is your religious/faith background?
10. Do you wear any cultural/religious clothing or a symbol? (e.g. hijab, kippa, turban, cross, etc.)
10. What is you age group?
10. Do you want SLAH to contact you for one-on-one support? (support can be emotional, connection to community resources, peer support, repairs, safety planning, reporting assistance, other community resources, etc.)  *This question is required.
11. Do you have any ongoing concerns regarding your wellbeing? *This question is required.
11. Is it safe to leave you a voicemail if you provided a phone number? *This question is required.