Make an anonymous report Thank you for your courage in making this report. Please note: SARA is for intelligence gathering only. If you want this matter taken further, contact Police or Crimestoppers. These fields will be supplied to the police Type of Incident (required) (Select one) Rape/Sexual assault Indecent exposure Stalking or following Touching Childhood sexual assault Sexual harassment Other Who did the incident happen to? (Select one) Me A Member of my family A friend An acquaintance Other Where and When Country the incident took place (Only Australian reports will be sent to the Police) (Select one) Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Antarctic Territory British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canton and Enderbury Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos [Keeling] Islands Colombia Comoros Congo - Brazzaville Congo - Kinshasa Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Côte d’Ivoire Denmark Djibouti Dominica Dominican Republic Dronning Maud Land Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories French Southern and Antarctic Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Johnston Island Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau SAR China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Metropolitan France Mexico Micronesia Midway Islands Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar [Burma] Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Vietnam Northern Mariana Islands Norway Oman Pacific Islands Trust Territory Pakistan Palau Palestinian Territories Panama Panama Canal Zone Papua New Guinea Paraguay People's Democratic Republic of Yemen Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Senegal Serbia Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria São Tomé and Príncipe Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Minor Outlying Islands U.S. Miscellaneous Pacific Islands U.S. Virgin Islands Uganda Ukraine Union of Soviet Socialist Republics United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wake Island Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands Australian State/Territory (Select one) Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Unknown Address or location of the incident When the incident took place About the Offender Offender name Offender address Offender gender (Select one) Male Female Unknown Offender eye colour (Select one) Blue Brown Green Hazel Unknown Offender hair colour (Select one) Bald Black Blond Brown Grey Red Unknown Other Offender appearance (Select one) Aboriginal African Asian Caucasian European Middle Eastern Unknown Offender height Is there anything else you remember about the offender? About the incident Tell us what happened Tell us as much or as little as you want. Even if you only remember partial details. Have you told anyone else about this incident? (Select one) No Yes Attach an photo * These fields will not be supplied to the police Contact details If you are in Australia and would like further action taken could you please leave your first name and a contact number. A SECASA worker will contact you within 48 hours or the next business day.If we have NOT contacted you please ring 03 9594 2289 and ask to speak with the duty worker about your SARA report. If you need to speak with someone now please ring the Sexual Assault Crisis Line (Victoria) on 1800 806 292 or 1800 RESPECT (Australia). * Your first name * Contact phone number (include area code) * Is it OK for us to leave a message or text you on this number? No Yes * Contact email address Disclaimer: Any information you provide to us is voluntary. We will take all reasonable steps to ensure your information is protected from modification, misuse, disclosure, loss and unauthorised access. Remember that no internet transmission is ever completely secure or error-free. SECASA and Monash Health will not be held responsible for events arising from unauthorised access to your information.