Thank you for taking the time to share your experiences of firework season with us.  Please be advised that by completing this form you are NOT reporting an incident that the RSPCA can respond to. If you wish to report cruelty, neglect or have seen an animal in urgent need you must call 0300 1234 999 to make your report. 



Privacy Notice

The information you share within this form will be stored securely on a password protected web application.  The partial postcode data you provide will be used to map and monitor firework incidents impacting animal welfare across England and Wales. We will also monitor this data to understand as best we are able the actions taken by residents to report incidents.  Hotspot locations and numerical statistics may be shared with local authorities or organisations responsible for the regulation of fireworks (BEIS) to inform local and national policy. 

Any case studies provided with consent to contact will not be used without your express permission and sign off and if used could be shared in the media, print press on television and in RSPCA campaign communications.  

All information shared with the RSPCA will be kept throughout the lifecycle of the #BangOutOfOrder campaign and then remain on files thereafter should you wish to access those records.  Please DO NOT complete this survey if you are under 16 years of age and ask a parent or guardian to submit your report on your behalf.



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* 1. Please can you provide the first 4 letters/numbers of your postcode and describe the type of location you believe the fireworks are coming from.

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* 2. Please provide the time and date of incident

Date
Time

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* 3. Please can you tick what type of firework event you believe caused the problem.

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* 4. Did you have advance warning fireworks would be set off and if so how were you warned?

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* 5. If you reported this incident please can you state to whom was the incident reported?

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* 6. Please can you tick the type of animal the incident involves? Please tick all that apply.

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* 7. Please can you provide a description of the fireworks incident and the impact it had on the animals concerned? For example, what happened, how the animal responded, whether any animal was injured or killed, how long their behaviour changed for, etc.

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* 8. If you have sought support or help for your animal’s fear response, can you indicate where from?

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* 9. If any of these sources were effective, can you indicate which one?

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* 10. Was this incident captured on video?




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* 11. Would you be happy for the RSPCA to contact you to discuss your experience?

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* 12. If the answer to question 11 is Yes, Please provide contact details below

Thank you for taking the time to complete this incident report form and please take care, this firework season. If your report is concerning a horse please also visit The British Horse Society https://bit.ly/2XjYYpW to share the details of your incident.
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