INTAKE FORM

If you feel in immediate danger, please call 911. If you need immediate mental health assistance and live in the following jurisdictions, please call

  • City of Berkeley Adult Mental Health Services, M-F 10 am – 5 pm (510) 981-5244;
  • City/County of San Francisco peer-run mental health talk line (855) 845-7415, and 24/7 crisis line (415) 970-3800;
  • Alameda County 24-Hour Crisis Line, (800) 309-2131.
When completing the following Intake Form, all information except for “Additional information such as context of incident(s)” may be shared with the person being reported. If you are filing a report on behalf of another community member, the Report Team will need to communicate with the other community member to corroborate your report.

If you have multiple incidents to report, please submit a separate Report Intake Form for each incident.

Please know that the Report Team may take up to two weeks to process your report, as Report Team members are part-time volunteers. We appreciate your patience. Also, the Report Team are DxE community volunteers, and we ask that community members refrain from targeting team members as individuals.

If you would like to propose amendments to the DxE Code of Conduct, including the Relationship Policy, please email report@dxe.io.

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