Reporting anti-social behaviour (ASB)
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Please give a detailed description of the anti-social behaviour incident that has affected you. Make sure that you include the following points to help us resolve your issue as quickly as possible.
Title: Required
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Mr
Mrs
Miss
Ms
Dr
Mx
Please enter title
Please provide your complete address by clicking on 'Find address' or 'Enter manually'.
Contact details - please provide at least one telephone number
Please enter at least 1 of the phone numbers
Best contact method: Required
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Email
Mobile phone
Home phone
Work phone
Please enter a preferred contact method
Where did it happen? Required
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In a Dacorum Borough Council property
In a privately owned or rented property
In a property managed by a Housing Association
In a communal space
Please select where it happened.
Please give more details and include any addresses. Required
Please enter where it happened.
Who did it, or who was involved? If it was someone you don’t know, please describe them: Required
Please say who was involved
Did anyone else witness it? Required
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Yes
No
Please select if there were witnesses.
Please give more details Required
Please include details about witnesses
Other than this occasion, how often do you have problems?Required
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Daily
Most days
Most weeks
Most months
Only occasionalls
Please specify.
Do you think the incident is linked to previous incidents? Required
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Yes
No
Please specify.
Please give more details Required
Please include details about if the incident is linked
Do you think that incidents are happening more often and/or are getting worse? Required
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Yes
No
Please specify.
Please give more details Required
Do you know the offender(s)? Required
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I know them well
We are ‘known’ to each other
I do not know them
Please specify.
Please give more details Required
Does the perpetrator (or their associates) have a history of or reputation for intimidation or harassment? Required
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They are currently harassing me
They have harassed me in the past
They have not harassed me, but have a history or reputation for harassment or violent behaviour
I am not aware of a history or reputation for harassment or intimidation
Please specify.
Please give more details Required
Have you informed any other agencies, including the Police, about what has happened?Required
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Yes
No
Please specify.
Please give more details Required
Do you think that this incident deliberately targeted?Required
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You
Your family
Your community
None
Please specify.
Do you feel that this incident is associated with your race, religion or belief, disability, sexual orientation or gender identity?Required
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Race
Religion / Belief
Disability
Sexual Orientation
Gender Identity
No
Please specify.
Please give more details Required
In addition to what has happened, do you feel that there is anything that is increasing you or your household’s personal risk? Required
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Yes
No
Please specify.
Please give more details Required
How affected do you feel by what has happened? Required
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Extremely affected
Affected a lot
Moderately affected
Affected a little
Not at all
Please specify.
Please give more details Required
Are you having suicidal thoughts?Required
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Yes
No
Please specify.
Has yours or anyone’s mental or physical health been affected as a result of this and any previous incidents? Required
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Yes
No
Please specify.
Please give more details Required
Do you have a social worker, health visitor or any other type of professional support? Required
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Yes
No
Please specify.
Please give more details Required
Do you have any friends and family to support you? Required
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I live alone and I am isolated
I am isolated from people who can offer support
I have few people to draw on for support
I have a close network of people to draw on for support
Please specify.
Apart from any effect on you, do you think anyone else has been affected by what has happened? Required
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Yes, the community or other
Yes, my Family
No
Please specify.
Please give more details Required
Please complete the validation below: