Free Info Survey
Complete this one-minute survey, help ICSA help others, join ICSA's mailing list, and gain access to free e-books and other resources. If you have difficulties, contact ICSA: mail@icsamail.com.  ICSA does not share its email or contact lists.
Sign in to Google to save your progress. Learn more
Last Name *
First Name *
What is your state or province? *
What is your country? *
What is your e-mail address? *
Are you a former member of a cultic or high-demand group? *
Were you born or raised in a cultic or high-demand group? *
If you are a former member of a cultic or high-demand group (or born or raised in one), approximately how many years were you in your group? Enter only one number - no text please. Use "1" if less than 1 year.
If you are a former member or a cultic or high-demand group (or born or raised in one), how long have you been out? *
Do you currently have a family member(s) in a cultic or high-demand group? *
Did you have a family member who was in a cultic or high-demand group and who is now out? *
Which of the following apply to you?
Mark all that apply; leave blank if none applies.
What is the name of the group that you and/or a loved one was/is involved with?
What is your age in years? *
Have you completed a similar ICSA survey in the past? *
So we won't count your responses twice in survey analyses.
Are you a mental health professional or student of a mental health field?
Clear selection
Are you pastor or other religious professional?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of International Cultic Studies Association.

Does this form look suspicious? Report

Google Forms