Ugly Mug Incident Report Form 22 Oct 2018 | About You Hello and welcome to the Incident Report form of Respect Inc. We take these reports very seriously. If you need to talk to someone urgently please call us directly on (07) 3835 1111 (Brisbane), 0413571394 (Cairns), 0416987011 (Townsville) or 0401969223 (Gold Coast). Ugly Mug Incident Reporting Form on the Respect Inc Website Date of incident Time of incident : HH MM AM PM Mobile number of Mug, if knownOnline identity of Mug, if knownLicence plate of Mug, if knownWhat gender is this mug?Man, cis-manMan, trans-manWoman, cis-womanWoman, trans-womanHow did the Mug find you? What advertising site etc:AgeWeightHeightBody TypeEye colour/shapeHair colourHair lengthHair type, curly/straightEthnicityAccentRegular?YesNosomeone elsesLocation of IncidentWas it private? In call or outcall? Address if knownWas it a brothel? Which one?Was it street based? What area?What happened? As much or as little as you want to share about the incidentAny more distinguishing features about the mug? Tattoos, beard, scarsAnything else about what the mug was wearing? Jewelry, bag, keysDo you wish this report to be shared within the sex worker community?YesNoDon't know, please contact meCan we distribute this for you on other sex worker platform?YesNoDon't know, please contact mePreferred contactThis incident happened to:MeMy friendAnother worker, I heard it third handI'm a peer educator making the report, the person gave me permission to do soI'm an MC member, the person gave me permission to reportI'm a volunteer, the person gave me permission to reportI don't know who it happened to, but heard about it and wanted to make a reportIf this incident happened to you, can you tell us a bit about yourself?I work as a cis-gendered womanI work as a trans-gendered womanI work as a cis-gendered maleI work as a trans-gendered male workerI work as a gender-fluid or NB workerNone of these fit my work stylesThis report is: Urgent Not urgent I don't know This incident has been reported before: No, this is the first time I've reported it to Respect Inc Yes, these are additional details for a report made to Respect Inc previously I don't know I would like this incident to be reported to the police: Yes No It's already been reported, no further action needed It's already been reported, can Respect Inc follow it up please I'm going to report it in the future, no further action needed I'm going to report it in the future, can Respect Inc follow it up please I would like Respect Inc to make an unidentified report to the police without using my name I would like Respect Inc to make an identified report using my name I don't know What police station is involved? (if known)Names of officers, details, such as date, what the officer looked likeDid the police take the report seriously? Yes No No report has been made I don't know If applicable, name which you are known to the police by (if Respect Inc don't need to know your name please don't fill this in): Thank you for filling in the Ugly Mugs report form for Respect Inc.