Forward Community Survey
ABOUT FORWARD. Forward is a new organization that is dedicated to helping adults who have left (or are considering leaving) their ultra-orthodox or chassidic communities. Our goal is to provide shelter, social support, and access to educational programs and social services. The purpose of this survey is to learn more about your current circumstances and needs, so that we can have the biggest impact as soon as possible.

CONFIDENTIALITY. The information collected in this survey will be anonymous and confidential. The survey will NOT ask for your name or contact information. All survey responses will be held in a password protected file. Only the Forward board will have access to these anonymous survey responses. If you have any questions or concerns about confidentiality, please contact Levi Riven at

Please also feel free to contact Levi if you have immediate needs and/or wish to learn more about Forward's services.

INFORMED CONSENT. This survey will include questions about your background, social circumstances, your experience leaving your Ultra-Orthodox or Chassidic community, and your current needs. The survey will take 10-15 minutes to complete. There are no known risks associated with taking this survey. However, you might find that thinking about these circumstances may arouse negative emotions. There is no obligation to complete the survey, and you may stop at any time. You will also have the option to skip any question by selecting the "Prefer not to say" option. Please note that this survey has not been approved by an institutional review board because this is not part of a public research project. All data will be used for internal use only.

I have been informed about the nature of this survey and consent to provide my anonymous information to Forward for internal use. *
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