Online Dating App Contact Block Request Form
Use this form to request that a specific contact on the dating app be blocked. Please provide accurate information to help us process your request efficiently.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Contact's Display Name or Username
*
Contact's Profile Link (if available)
Reason for Block Request
*
Please Select
Harassment or inappropriate messages
Spam or scam activity
Impersonation or fake profile
Unwanted contact
Other
Please describe your reason for this request
*
Upload supporting evidence (screenshots or messages, optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
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How did you interact with this contact?
Please Select
Matched and messaged
Only matched
Saw profile only
Other
Date of last interaction (if known)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Block Request
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