Ugly Mug Incident Report Form

Date of incident

Time of incident

:

Mobile number of Mug, if known

Online identity of Mug, if known

Licence plate of Mug, if known

What gender is this mug?

How did the Mug find you? What advertising site etc:

Age

Weight

Height

Body Type

Eye colour/shape

Hair colour

Hair length

Hair type, curly/straight

Ethnicity

Accent

Regular?

Location of Incident

Was it private? In call or outcall? Address if known

Was 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 incident

Any more distinguishing features about the mug? Tattoos, beard, scars

Anything else about what the mug was wearing? Jewellery, bag, keys

Do you wish this report to be shared within the sex worker community?

Can we distribute this for you on other sex worker platform?

Preferred contact

This incident happened to:

If this incident happened to you, can you tell us a bit about yourself?

This 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 like

Did 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):

Ugly Mug Incident Report Form

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

Thank you for filling in the Ugly Mugs report form for Respect Inc.

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