GIRL SEXUAL ABUSE & ONLINE EXPLOITATION HELPLINE FORM Confidential Women Safety & Digital Protection Support Form Is This Situation Currently An Emergency? *Yes — Immediate Help RequiredSerious But StableNeed Guidance & SupportUnsureWhat Type Of Situation Are You Facing? *Online Sexual BlackmailingSextortionFake Nude / MorphingDeepfake AbuseThreatening MessagesForced Video CallsIntimate Photo Leak ThreatCyber StalkingSocial Media HarassmentHidden Camera ConcernRelationship ExploitationRevenge Porn ThreatWhatsApp / Telegram ExploitationFake Profile MisuseEmotional ManipulationOtherIs The Abuser Known To You? *YesNoUnsureIs Your Safety Or Mental Peace Currently At Risk? *YesNoUnsureHas Any Sensitive Content Already Been Leaked Publicly? *YesNoUnsureDo You Feel Unsafe Right Now? *YesNoFull Legal Name *Age *Date of Birth *Gender *Female OnlyNationality *Full Address *Current State *Country *Father’s Name *Mother’s Name *Marital Status *SingleMarriedDivorcedWidowHusband’s Name (If Applicable) *Highest Qualification *School Student10th Pass12th PassDiplomaGraduatePost GraduateOtherOccupation / Current Status *School StudentCollege StudentWorking ProfessionalHomemakerBusinessInfluencer / CreatorOtherAre You A Minor (Below 18)? *YesNois Guardian Aware Of The Situation? *YesNoPrimary Mobile Number *WhatsApp Number *Email Address *Safe Contact Method *WhatsAppCallEmailBest Time To Contact You Safely *Is It Safe For Our Team To Call You Directly? *YesNoPlease Explain What Happened In Detail *When Did This Incident Start? *TodayWithin Last 7 DaysWithin Last 30 DaysMore Than 1 Month AgoWhich Platforms Are Involved? *InstagramWhatsAppTelegramSnapchatFacebookX / TwitterDiscordDating AppsGoogle MeetZoomOtherWhat Does The Abuser Want? *MoneyMore Photos/VideosSexual ExploitationEmotional ControlRelationship PressurePublic HumiliationRevengeUnknownHave You Shared Any Sensitive Images/Videos Under Pressure? *YesNoAre You Being Threatened Right Now? *YesNoHave You Blocked The Person? *YesNoHas Any FIR / Police Complaint Already Been Filed? *YesNoHave You Told Anyone Else About This Situation? *YesNoHow Is This Situation Affecting You? *earAnxietyPanicDepressionSleeplessnessSocial FearEmotional BreakdownReputation FearFamily PressureSuicidal ThoughtsMental StressOtherWhat Is Your Biggest Fear Right Now? *Do You Have Any Of The Following Evidence? *ScreenshotsChat BackupAudio RecordingVideo RecordingFake Profile LinkPayment ProofThreat MessagesPhone NumbersEmail RecordsSocial Media IDsNoneUpload Screenshots / Evidence *Drag and Drop (or) Choose FilesUpload Aadhaar Card Front Side *Choose FileNo file chosenDelete uploaded fileUpload Aadhaar Card Back Side *Choose FileNo file chosenDelete uploaded fileUpload Your Latest Three Photo *Drag and Drop (or) Choose FilesDo You Agree That Additional Identity Verification May Be Requested In Sensitive Or High-Risk Cases? *YesNoWhat Kind Of Help Are You Looking For? *Guidance & SupportFake Content Removal AssistanceFake Profile Reporting HelpCyber Safety GuidanceEmotional Support GuidanceOnline Reputation ProtectionDigital Privacy HelpEmergency ConsultationOtherDo You Want Priority Emergency Support? *YesNoAre You Comfortable Joining A Confidential Google Meet Session If Required? *YesNoDo You Confirm That The Information Provided By You Is Accurate & Genuine? *YesNoDo You Understand That False, Fake, Or Misleading Complaints May Result In Rejection Or Legal Escalation? *YesNoDo You Agree That Your Information Will Be Handled Under Strict Privacy-Focused Operational Protocols? *YesNoDo You Understand That Submission Of This Form Does Not Replace Official Emergency Or Law Enforcement Services? *YesNoSignature *Start signing your signature hereYour browser does not support e-Signature field.Consent *Yes, I agree with the privacy policy and terms and conditions. SubmitSave as Draft
