undefined

Intake forms for human trafficking victims

This human trafficking intake form is designed to help service providers quickly and easily identify potential human trafficking victims and gather information to assist in providing them with the services they need. The form may include sections on identifying information, background information, trafficking indicators, and service needs.

2 minutes to complete

Eligibility

There are no specific eligibility criteria for filling the intake forms for human trafficking victims. However, the victims must be willing to provide information and cooperate with the authorities in order to get the benefits.

undefined

Questions for Intake forms for human trafficking victims

Questions

1.

Name

The answer should be a text input.
2.

Date of Birth

The answer should be a date input.
3.

Address

The answer should be a text input.
4.

Phone Number

The answer should be a phone number.
5.

Email Address

The answer should be an email input.
6.

Do you feel like you are in danger?

The answer should be a single choice:
  1. Yes
  2. No
7.

Do you feel like you are being held against your will?

The answer should be a single choice:
  1. Yes
  2. No
8.

Do you feel like you are being forced to do something against your will?

The answer should be a single choice:
  1. Yes
  2. No
9.

Has anyone threatened you or your family?

The answer should be a single choice:
  1. Yes
  2. No
10.

Do you have any injuries?

The answer should be a single choice:
  1. Yes
  2. No
11.

Do you feel like you are being exploited?

The answer should be a single choice:
  1. Yes
  2. No
12.

Do you feel like you are being forced to engage in commercial sex acts?

The answer should be a single choice:
  1. Yes
  2. No
13.

Do you feel like you are being forced to work against your will?

The answer should be a single choice:
  1. Yes
  2. No
14.

Has anyone taken your passport or other identification documents?

The answer should be a single choice:
  1. Yes
  2. No
15.

Do you owe anyone money?

The answer should be a single choice:
  1. Yes
  2. No

Forms Similar to Intake forms for human trafficking victims

  • Intake forms for survivors of sex trafficking form
  • Intake forms for survivors of labour trafficking form
  • Intake forms for survivors of human trafficking

Here are some FAQs and additional information
on
Intake forms for human trafficking victims

How does the human trafficking intake process work?

The first step is for the victim to contact a human trafficking intake specialist. The specialist will ask the victim a series of questions to determine if they are eligible for services. If the victim is eligible, the specialist will connect them with services and provide support throughout the process.

What types of services are available to human trafficking victims?

Human trafficking victims can receive a range of services, including legal assistance, housing, counselling, and medical care.

How can I get help if I am a victim of human trafficking?

If you are a victim of human trafficking, you can contact a human trafficking intake specialist to get help.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Intake forms for human trafficking victims

1000+ Templates, 50+ Categories

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE