Rochford District Council logo
Section Navigation Bar

    Domestic Abuse Reporting Form


    Before continuing, please read 'Staying Safe on the Internet' (PDF 17kb).


    This form is to report an incident of domestic abuse, in an emergency always dial 999

    This form can be used if you have been a victim of domestic abuse, if you have witnessed an incident of domestic abuse, or if you are reporting an incident on behalf of someone else.

    Any information you submit will be kept confidential and only shared with relevant agencies and departments should you indicate that this is acceptable.

    However if any offences are disclosed or we feel that there is a high risk of potential harm we are obliged to pass this on to the appropriate departments as a matter of urgency.

    eForms by AchieveForms