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Report Abuse or Violation

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/ Report Abuse or Violation

Report Abuse or a Policy Violation

Use this form to report instances of abuse, violations of Scouting America policies, or inappropriate behavior involving Scouts, Scout leaders, parents, or others.

General Details

Incident Date(Required)

MM slash DD slash YYYY

Date Reported to Council(Required)

MM slash DD slash YYYY

Council/Location Where Incident Occurred (If Applicable)

Incident Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Type of Report:(Required)

Suspicion or Allegation of Abuse

Scouting America Policy or Guideline Violation(s)

Other Inappropriate Behavior by a Scout, Scout Leader, Parent or Other Individual

Details of Incident (Clear, Concise, Complete Facts)(Required)

What the alleged victim, target, or injured party said; What the reporter observed or was told; Any similar or past incidents involving the victim, target, or injured party; Any similar or past incidents involving the violator or offender; Etc.

Reporter Information

Reported By: Name(Required)

First Last

Reported By: Scouting Position(Required)

Reported By: Primary Phone(Required)

Reported By: Secondary Phone

Reported By: Email(Required)

Reported By: Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Add Additional Reporter?

Yes

Additional Reporter Information

Reported By: Name

First Last

Reported By: Scouting Position

Reported By: Primary Phone

Reported By: Secondary Phone

Reported By: Email

Reported By: Address

Street Address City State / Province / Region ZIP / Postal Code

Alleged Victim, Target, or Injured Party Information

Alleged Individual is a(n):(Required)

Adult

Youth

Registered

Other

Other (Please Specify):

Alleged Individual: Council(Required)

Alleged Individual: Unit(Required)

Alleged Individual: Chartered Organization(Required)

Alleged Individual: Name(Required)

First Last

Alleged Individual: Gender(Required)

Alleged Individual: Date of Birth(Required)

MM slash DD slash YYYY

Alleged Individual: Age(Required)

Alleged Individual: Parent(s) Name(Required)

First Last

Alleged Individual: Primary Phone(Required)

Alleged Individual: Secondary Phone

Alleged Individual: Email(Required)

Alleged Individual: Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Parents Notified?(Required)

Yes

No

Notified By:(Required)

Date Parent Notified:(Required)

MM slash DD slash YYYY

Time Parent Notified:(Required)

Hours

:

Minutes

AM/PM

Alleged Offender Information

Alleged Offender is a(n):(Required)

Adult

Youth

Registered

Other

Other (Please Specify):

Alleged Offender: Council(Required)

Alleged Offender: Unit(Required)

Alleged Offender: Chartered Organization(Required)

Alleged Offender: Name(Required)

First Last

Alleged Offender: Gender(Required)

Alleged Offender: Date of Birth(Required)

MM slash DD slash YYYY

Alleged Offender: Age(Required)

Alleged Offender: Parent(s) Name(Required)

First Last

Alleged Offender: Primary Phone(Required)

Alleged Offender: Secondary Phone

Alleged Offender: Email(Required)

Alleged Offender: Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Parents Notified?(Required)

Yes

No

Notified By:(Required)

Date Parents Notified:(Required)

MM slash DD slash YYYY

Time Parents Notified:(Required)

Hours

:

Minutes

AM/PM

Reports Made

Was This Incident Reported to Law Enforcement?(Required)

Yes

No

Unsure

Name of Law Enforcement Agency:(Required)

Date Report Was Made:(Required)

MM slash DD slash YYYY

Approximate Time Report Was Made:(Required)

Hours

:

Minutes

AM/PM

Were Appropriate Children and Family Services/Child Protective Agencies Notified?(Required)

Yes

No

Unsure

Not Applicable

Name of Agency:(Required)

Date Agency Was Notified:(Required)

MM slash DD slash YYYY

Approximate Time Agency Was Notified:(Required)

Hours

:

Minutes

AM/PM

File Upload

Attachments such as photos and statements can be helpful when making a report of incident.

File

Max. file size: 2 GB.

Δ

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Call: (513) 577-7700 | Fax: (513) 577-7738

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