Survivor Support Group Buddies and Guidelines
This form will help us pair you with a support buddy... we want you to feel safe in all meetings and with your buddy! Remember, none of these buddies have to be permanent.
This form is NOT anonymous as we (Abby, Kaeli, Cece, and Sophia only) need to know who you are to pair you.
Phone and/or email *
We don't need your name, but we do need some way to contact you and pair you.
What do you need from here?
Potential triggers we should be thoughtful of?
Are you interested in doing our buddy system
Clear selection
If applicable, would you prefer your buddy to be a survivor?
Clear selection
Is there someone in particular you would want to buddy with?
Is there someone in particular you would not be comfortable with being your buddy?
Is there a specific situation or topic you need help with, that you would like to have in common with your buddy
Is there any experience or topic that you feel passionate or open to share about to potentially help  others get through a similar situation?  ie. online consent, reporting
How far along are you in the healing process?
Clear selection
How can you communicate with your buddy? Please check all that apply.
Resources and Their Details (there are some great anonymous options here!)
https://docs.google.com/document/d/1OcQD4Baq-r0vSDUi0H6zoOE-jaZXFkY1DfIW-cYH-2w/edit?usp=sharing 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Piedmont Unified School District. Report Abuse
Google Forms