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Report a Bad Date
Report a Bad Date

Bad Date & Aggressor Report Form

Note that an asterisk (*) indicates a section that must be completed.

Please fill out all required (*) sections before proceeding

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    • Bad Date & Aggressor Report Form

      *asterisk indicate a section that must be completed.

    • General Incident Information

    • Time and Location information

    • (Check all that apply)
    • (Check all that apply)
    • (Check all that apply)
    • Offender Information

    • (Check all that apply)
    • (Check all that apply)
    • If you would like a text sent to you confirming that this bad date report has been received please enter your cell phone number above. This will also give you a link that allows you to later edit this bad date report. This phone information is deleted after the text is sent and is not stored in any way.
      If Yes, please provide contact information in the following fields so that Peers may contact you.
      This option is to connect with a plain clothes VicPD officer and can be via email, phone or in person to discuss options, get information and/or make a formal report. You may have a support person with you, such as the Violence Prevention Peers worker, to make a report.
    • This is the end of the general report. If you have additional details to share, click "Continue With More Details" or “Next”. If you have provided all the information you can, click “Submit Now”.

    • Additional Offender Information

    • Additional Vehicle Information

      (Check all that apply)
    • Other Information

    • Drop files here or
      Max. file size: 20 MB.
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    Peers Victoria Resource Society

    1-744 Fairview Road, Victoria, BC V9A 5T9

    General Contact: 1 (250) 388-5325

    admin@peers.bc.ca

    Night Outreach: 1 (250) 744-0171

    outreach@peers.bc.ca

    Fax: 1 (250) 388-5324

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