Story Reporting Form

Share Your Story

In the face of violence, the first act of resistance is to speak. Have you experienced or witnessed a case of GBV? Share your testimony, report it, make your voice heard.

Fill out this form confidentially to share your story

Who are you reporting the incident for?

For myselfFor someone else

age

Gender

FemaleMalePrefer not to say

City

Type of violence

Can you tell us what happened?

When did the incident occur?

At what time? (approx.)

Was the incident reported to the police?

YesNoI will do it in the future

Is there anything else about the incident?

Please indicate the location of the incident: (Please move the marker to the exact location)

Share Your Story

Categories

Interventions

Violence

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