Social Media Live Stream Incident Report Form
Report and document incidents that occur during live social media streams. Please provide detailed and accurate information to help us address the issue effectively.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Social Media Platform
*
Please Select
Facebook Live
Instagram Live
YouTube Live
Twitch
TikTok Live
Other
Livestream Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Stream Title or Link
*
Type of Incident
*
Harassment or Bullying
Hate Speech
Graphic or Violent Content
Spam or Scams
Technical Issue
Other
Incident Severity
*
Low – Minor disruption
Moderate – Ongoing or repeated issue
High – Significant risk or harm
Describe the Incident
*
Immediate Action Taken
*
Reported to platform
Stream paused or ended
User blocked or muted
No action taken
Other
People Affected (Briefly describe or list usernames, if known)
Preferred Follow-Up Method
*
Email
Phone call
No follow-up needed
Submit Report
Should be Empty: