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Manual Case Entry — Use this form to register complaints received via phone, in-person visit, or letter. Online submissions are automatically captured.

Complainant Information

Full Name * Please enter the complainant's name

Filing As

Phone Number Please enter a valid Gambian phone number

Email Address Please enter a valid email address

Preferred Language

Preferred Contact Method

Victim Information Filing on behalf of victim

Since you are filing on behalf of another person, please provide details about the victim(s) of the alleged violation.

Victim's Full Name *

Relationship to Complainant *

Victim's Age (or approximate)

Victim's Gender

Victim's Contact Phone (if available)

Victim's Address (if available)

There are additional victims involved in this case

Victim has given consent for this complaint to be filed on their behalf

Incident Details

Violation Type * Please select a violation type

Date of Incident * Please enter a valid date (must be after 24 January 2017)

District * Please select a district

Village/Settlement

Incident Type

Single incident Ongoing situation Multiple incidents

Description of Incident * Please provide a description (minimum 50 characters)

Respondent Information Optional

Respondent Type

Respondent Name

Additional Details

Case Management

Priority Level

Assign To

Submission Channel

Date Received

Confidentiality requested — Restrict complainant identity to authorized staff only

Internal Notes

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