• Before you continue, you need to be aware that this form will give you two options before submitting:
    • You can submit with your name and details, and we will treat the form as a report that requires action. This means we will get in touch with you as soon as we can to discuss how best to support you.
    • You can submit anonymously, which means we will use the information for data collection purposes only. We will not make further contact with you about your issue, but will use the information you provide to help us direct resources to better support students.
    Keep this in mind as you complete the form. If you are going to submit anonymously, please do not give any identifying information about anyone involved in the incident or issue you’re reporting, as we will have no power to follow up.

    This form does not allow you to make a formal complaint to the University. It is a Students’ Union form, which means your information will only be handled by Students’ Union staff and used - depending on whether you choose anonymity – for information purposes or to advise you on your next steps. If you have tried to resolve your issue with the relevant people and have now decided to make a formal complaint to the University rather than the Students’ Union, you will need to follow the UCA Student Complaints Policy, instead of using this form. The policy can be found at ucasu.com/union/complaints/. You can get further information about how to submit a formal University complaint at Stage 1 from the Students’ Union, Gateway Services or your Campus Registry.

  • If you are in an emergency situation that requires the police, ambulance or fire service, please STOP now and contact emergency services on 999. You can always return to this form to make a report when the urgency of your situation has passed.

    If you have been sexually assaulted or raped, your first step should be to urgently visit a sexual assault referral centre (SARC) where you can be cared for by support workers and medical professionals. You can find your nearest SARC through the NHS website.

    If your situation needs quick attention but is not life-threatening, you can also get immediate medical advice on the NHS phone number 111.

    If you’re having suicidal thoughts, you can call Samaritans 24 hours a day, on 116 123.

  • Please select the field that best describes the issue you want to report
  • It’s important for us to know if you’re under 18 as it might affect the advice we give you and the services that are available to support you.

    If your issue is time-sensitive, Childline is available 24 hours a day to offer you advice and support on 0800 111. You can always submit a report to us at a later date.
  • Please ensure if you are reporting on behalf of someone else, particularly if the issue is of a sensitive or criminal nature, that you have that person’s permission to share information about the issue with us.
  • If unsure, please give an estimate.
  • If unsure, please give an estimate.
  • If unsure, please give an estimate.
  • If unsure, please give an estimate.
  • Please give details of the incident(s). The more detail you provide, the better we will be able to help and assist you.

    If you only wish for this report to be used for information gathering purposes, please do not give us any identifying information about yourself or anyone involved.
  • Please give details of the issue. The more detail you provide, the better we will be able to help and assist you.

    If you only wish for this report to be used for information gathering purposes, please do not give us any identifying information about yourself or anyone involved.
  • If you wish to submit this report anonymously, we can use the information provided as evidence to work on issues going forward. Unfortunately, we cannot help you with this issue directly if you wish to remain anonymous.

    If this is an issue that you would like further support and advice with, please select that option below.
  • If you wish to submit this report anonymously, we can use the information provided as evidence to work on issues going forward. Unfortunately, we cannot help you with this issue directly if you wish to remain anonymous.

    If this is an issue that you would like further support and advice with, please select that option below.
  • You should submit this form with your name and information
    if you want us to take action on your report. We will recognise this report as a request for action and get in touch with you to discuss next steps, ensuring you feel secure and supported.

    In the meantime, if you need to speak to someone for your own wellbeing, here are some of your options:

    UCASU Advice (open 8am-4pm on weekdays): 01634 88 8754
    Samaritans (open 24 hours a day): 116 123
    If you have not heard back from us within three working days of submitting this report, please feel free to contact UCASU Advice on 01634 88 8754 or advice.su@uca.ac.uk

    By completing this form, you give us permission to store your details so we can contact you. We will only use your details to contact you in relation to your submission of this form.
  • If you submit anonymously, this means we will take no action on your report. Instead, your information will be logged by us and used in the following ways:

    • Creating statistical reports and analyses about UCA student life
    • Understanding what issues we need to allocate more money and staff time to, to better support UCA students
    • Providing statistical evidence to the university about where resources should go, to improve students’ lives

    The details of your report will never be shared outside of the Students’ Union. Your report encourages UCA students to speak up and helps us to work together to make students’ lives better.