If you are in immediate danger, then contact the police by ringing 999 immediately

Please use this form to report an anti social behaviour incident to us

In order for your report to be actioned, we need to know your name and address. Without it, we will not be able to proceed further. If you do not wish to be named, simply tick the box to ask to remain anonymous.

Full Name:

Address:

Telephone Number:

Mobile Number:

Email Address:

Are you the complainant?

Do you want to remain anonymous?

Ethnicity:

We need to collect this information to enable us to establish if people of different ethnic origins are being disproportionately affected by ASB. Just so you are aware, we may share this data with other agencies who are working with us to resolve your ASB case e.g. the police, where they have requested the information from us. By giving us this information, you are giving us permission to use and share it in the way we have explained. This field is not mandatory and you can proceed with submitting this form should you choose to not give this information.

Date and Time of the Incident:

Type of Incident (e.g.: noise):

Identity of perpetrator:

Perpetrator's address if known:

Where exactly did the incident take place?

What exactly happened and/or what was said?

Did you retaliate?

How has it affected you?

Name of your housing manager:

Have you reported this to any other organisation (i. e. Police, Environmental Health, Social Services)?

Who to?

Provide any crime reference number:

Do you have any other information you want us to know?

Data Protection & Security

Bromford Housing Group Ltd, which includes Bromford Housing Association Ltd, Fosseway Housing Association Ltd and Bromford Home Ownership Ltd (trading as Bromford and Bromford Homes (previously Bromford Living, Bromford Support and Group)) will keep your personal information secure and confidential. We collect this information (and may share some or all of it with third parties) as part of:
- Providing, and where necessary improving, services to all our customers: housing & neighbourhood management services; home ownership products & services; support services
- As well as, where appropriate: preventing and detecting crime, fraud and unpaid debts; providing help with debt management and benefit entitlement; providing employment, training advice and opportunities; promoting equal opportunities and fair treatment.
If you provide us with personal information relating to members of your family or your associates we will assume you do so with their knowledge and consent to the collecting and processing of the information.
It is important that you tell us of any changes to your personal information as and when they happen so we can keep your details up to date.
For more information on how we use and share your information please refer to our Privacy Notice which is on our website. However, if you would like a written copy of this please contact Customer Services.

Submit my form

When you have completed the form, please press the button marked 'submit' below to send your form to us.