First Information Report (FIR) Questionnaire
For every woman that reports sexual violence, there are many that do not, due to many reasons, including security, social stigma & discrimination. Amnesty International India's campaign aims to ensure that women are able to report violence safely, with dignity and without facing prejudice.
We would like to invite women who have chosen to report sexual violence or harassment to the authorities to fill out this short questionnaire. If you would rather do this interview in person, please email us on
To learn more about how to report sexual violence, visit
We understand & acknowledge that sharing may be a difficult process for some, but we truly believe that this campaign cannot succeed without the inputs of those whose voices it is speaking for and with. Please tick one of the following options:
Use my information and my name
Use my information but not my name
Don’t use my information or name
Page 1 of 5
Never submit passwords through Google Forms.
This form was created inside of The Random Lines.