National Stalking Helpline Enquiry Form

At the stalking helpline we offer practical advice to victims to increase their safety and allow them to make informed choices.

We are a confidential service, any data we collect is kept on a secure system and we adhere to strict data protection protocols. We will not share information with anyone without your explicit consent, unless we felt that you or someone else was at risk of harm.

We may from time to time use your anonymised data for funding and evaluation purposes.
The following questions are entirely optional. If you do not want to answer any of the questions you are not obliged to do so.

Name: (required)

Email: (required)

Telephone No.

Address

Postcode

If you are completing this on someone else’s behalf, please ensure the details below correspond to the person being stalked:

D.O.B (required)

County or London Borough (alphabetical) (required)

Gender Identity (required)

Sexual Orientation (required)

Religion (required)

Disability status (required)

Ethnicity (required)

How long has the stalking been going on for? (max.250 words) (required)

Who do you believe is stalking you and what is your relationship (if any)? (max.250 words) (required)

What is the stalker doing? (max.250 words) (required)

What impact is the stalking having on you? (max.250 words) (required)

What are your main concerns/fears? (max.250 words) (required)

Is anyone else affected by the stalking, e.g children, family, friends, colleagues etc? (max.250 words) (required)

Have you contacted the police? If so, what has their response been? (max.250 words) (required)

Are you happy to be contacted by our policy team for future research? (If yes, please provide your email address and telephone number) *: (required)

YesNo

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