Care Card
Use this form if something is bothering you that you'd like to discuss with someone you can trust.
What is your concern?
Your answer
Who are you concerned about?
Your answer
When and where does it usually happen?
How does it make you feel?
Who would you like to share your concerns or problems with?
Name
Leaving your name is not required but it helps us to follow up if more details are needed.
Your answer
Submit
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