Report an Incident — AC2 QueerCare

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Civil Incident

Discrimination, hate speech, unfair dismissal, housing disputes, illegal eviction

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Criminal Case

Assault, rape, robbery, harassment, sexual violence, threats, property crime

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Asylum Seeker

Asylum application, refugee status, permit issues, deportation threats, protection risks

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Gender Marker Change

Update sex descriptor or name at Home Affairs, legal assistance with ID documents

Consent

Personal

Incident

Offenders

Support

Submit

POPIA Consent

Personal Details

Full Name(s)*

Surname*

Cellphone*

Alternative Number

ID / Passport*

Date of Birth

Age

Gender*

Sexual Orientation*

Sex

Race

Marital Status

Nationality*

Other Nationality

Country of Origin

Home Language

Education Level

Employment Status

Physical Address*

Province

District

Municipality

Offender / Perpetrator Details

Name (if known)

Relationship to You

Description of Offender

Was it reported to SAPS?

SAPS Case Number

Support Required

Assistance Needed

Legal Assistance Medical Assistance Psychosocial Support Safe Housing

Urgency Level

Additional Notes

Review & Submit

Please review your information before submitting. Once submitted, a reference number will be issued and our legal team will contact you within 3 business days.

✅ Consent given · Personal details captured · Incident details captured · Support requirements noted

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Report Submitted

Thank you for reaching out to AC2. Your report has been received and a reference number has been issued.

Our legal team will contact you within 3 business days. Please keep your reference number safe.

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