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Report a human rights abuse

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Submitted by admin on January 13, 2011 - 10:37pm

Name of Person Reporting Abuse | Nombre de persona reportando el abuso: *

Phone Number | Numero de Telefono:

Email Address | Correo electronico: *

Please describe the abuse or rights violation | Favor de describir el abuso o violacion de sus derechos: *

When did the abuse happen? | Cuando ocurrio el abuso (fecha):

Where did the abuse take place? | Donde ocurrio el abuso? (lugar):

Who else did you report the abuse to and what did they do? | Reporto el abuso a alguien mas, y como respondieron?: *

Do you need immediate assistance or referral? | Necesita ayuda inmediata o informacion?:

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