Bad Date Reporting

The information you provide will be kept anonymous.

We will not be collecting any identifiable information about you, just the Bad Date. The purpose is to help others know who to avoid and situations to be aware of.

Two ways to submit a Bad Date Report:

1 Download and email your completed Bad Date Reporting Form to swanwaterlooregion1@gmail.com

2 Fill out the online reporting form below and click Submit when you are finished.


Physical Description of Bad Date


Incidence Type (check all that apply)


Vehicle Description

Thank you for submitting your Bad Date report.