Military Feedback Form

If you have questions, comments, or complaints about the services on your installation/base or provided by a Sexual Assault Response Coordinator (SARC), victim advocate or other military staff or personnel, please use this feedback form. You can submit the form anonymously if you prefer. The information you provide on this form will be forwarded to the DoD Sexual Assault Prevention and Response Office (SAPRO).

If you believe you have experienced or witnessed retaliation in any form from a peer, supervisor or someone in your chain of command following a report of sexual assault, you can share the retaliation allegations with SAPRO using this form.

If you would like to submit a retaliation report, please report directly to the Department of Defense Inspector General (DoD IG)  here.

For members of the Coast Guard who have experienced retaliation, the Department of Homeland Security (DHS) IG will accept retaliation complaints as falling within the scope of their responsibilities for Whistleblower protection.  Coast Guard Members who have experienced retaliation can contact the DHS IG by calling 1-800-323-8603 (toll-free) or access the Allegation Form online

Information you provide on this form will be forwarded to the DoD Sexual Assault Prevention and Response Office (SAPRO).

* indicates a required field

Military Feedback Disclosure

If you have problems with this form, please contact DoD SAPR directly at whs.mc-alex.wso.mbx.SAPRO@mail.mil.

DD Form 2985-1, "Department of Defense Sexual Assault Prevention and Response Office (SAPRO) Military Feedback Form," January 2018

OMB CONTROL NUMBER: 0704-0565

OMB EXPIRATION DATE: 09/3o/2021

Reports Control Symbol: DD-P&R(AR)2665

The public reporting burden for this collection of information, 0704-0565, is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR RESPONSE TO THE ABOVE ADDRESS

Privacy Act Statement

Authority10 U.S.C. 1561 note, Improved Sexual Assault Prevention and Response in the Armed Forces;  DoD Directive 6495.01, Sexual Assault Prevention and Response (SAPR Program); DoD Instruction 6495.02, Sexual Assault Prevention and Response (SAPR) Program Procedures. 

Principal Purpose(s): To track victim-related inquiries received by the Sexual Assault Prevention and Response Office (SAPRO) via e-mail, SAPR.mil, the DoD Safe Helpline, phone, or postal service.  Once received, inquiries are referred to the appropriate agency POC and/or to the DoD IG in order to address the issue(s) raised and facilitate a resolution.  To allow individuals to provide feedback on the services of a SARC, victim advocate, or other military staff or personnel on their installation/base. This form does not constitute a report of sexual assault.

Routine Use(s): Disclosure of records are generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, as amended. 

To contractors, grantees, experts, consultants, students, and others performing or working on a contract, service, grant, cooperative agreement, or other assignment for the federal government when necessary to accomplish an agency function related to this system of records. Additional, routine uses may be found in the applicable system of records notice, DHRA 18 DoD, DoD Sexual Assault Prevention and Response Office Victim Assistance Data Systems at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-Component-Notices/OSDJS-Article-List/

Disclosure: Voluntary; however, failure to provide information may result in the inability to provide requested services.

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