Questionnaire

IMPORTANT: PLEASE DO NOT give any details of exactly what happened during the abuse. We are NOT looking for details of what happened. We are looking for the relationship to the abuser, ages, the time frame it happened, what caused it to stop – or what could have stopped it – and how it affected people.

**If you feel you need to share details, please contact us directly so we may direct you to someone in your area who can help you through your situation.***

Please enable JavaScript in your browser to complete this form.

Have you or someone you know been sexually abused? *

• Yes
• No

Definition of "sexual abuse" is up to you

Who was the abuser? *

Do NOT give a name, we are looking for how that person was related to you. IE.. parent, sibling, neighbor, teacher, another kid, parent's friend, or total stranger.

Did anyone else know about the situation? *

• Yes
• No

How did they find out?

Did they do anything about it?

• Yes
• No

Approximately how old were the people when the abuse started? *

Did abuse continue from the same aggressor or was this an isolated incident? *

• Yes
• No

If applicable, how often did it occur?

How long did the abuse continue?

Did it escalate?

• Yes
• No

people been they

How long from first incident to escalation?

What caused it to stop (if it has stopped)

Was there something that could have stopped the abuse sooner?

Did the police or legal system become involved? *

• Yes
• No

At what point?

How did they become involved?

How did they handle your situation?

Did they ask questions that made the situation worse for you or the person involved? *

• Yes
• No

What do you wish they had done differently?

Where there other abusers? *

• Yes
• No

During the same time frame - or later in life?

Anything (NO DETAILS) else you wish to share?

Contact:

If you wish to be contacted, please include the best way to contact you.

Name

Phone

Email

Submit