Share anonymously

Help us understand what our community needs.

This form is anonymous — we don't ask for your name or contact details. Your answers help iCare shape better support around mental health, GBV prevention, addiction, youth empowerment, and care for the elderly and special communities.

If you're in immediate danger or crisis:

Please contact a local emergency service or crisis line right away. Because this form is anonymous, we cannot reach you directly or respond in real time.

1. Which age group do you fall into?

2. Which of our focus areas affects you or someone close to you most right now? (select all that apply)

Mental health Gender-based violence Addiction Boychild / girlchild empowerment Elderly / special communities support None of these apply to me

3. What's the biggest mental health challenge you see in your community? 4. Do you feel there is enough awareness about gender-based violence where you live? 5. What would help a survivor of gender-based violence feel safe enough to seek support?

6. What kind of support do you think helps most with addiction recovery?

Counseling / therapy Peer support groups Family involvement Education / awareness programs Not sure

7. In your community, do boys and girls generally have equal opportunities? 8. What's one challenge you think elderly people or special communities face where you live?

9. What type of resources would be most useful to you or your community?

Workshops / training One-on-one counseling Helplines / hotlines Peer support groups Online articles / social media content

10. Have you or someone you know ever reached out for help with any of the issues above? 11. What would make it easier for someone to reach out for support? 12. Anything else you'd like to share with us, anonymously? Please avoid including your name, phone number, or anything that could identify you.

We don't collect names, emails, or identifying info through this form. This website form is currently a private front-end prototype and does not transmit responses until a secure survey service is connected.