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* 1. Email Address

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* 2. Name

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* 3. Date Of Birth (day/month/year)

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* 4. Phone Number

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* 5. Is it safe to leave a message on your voicemail?

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* 6. Address

Questions About You.  Please answer what you can: if there’s something you’re unsure about or don’t feel comfortable answering here, feel free to skip that question.

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* 7. Do you have lived experience of commercial sexual exploitation and/or domestic trafficking?

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* 8. Have you exited the life of commercial sexual exploitation and/or domestic trafficking for one year?

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* 9. Do you feel as though your basic needs like food, clothing, shelter and physical safety are well taken care of at this point?

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* 10. Are you engaged in mental health and/or addiction recovery? If this applies to you, can you briefly describe what your “recovery” looks like? For example, you might see a mental health counsellor once a week, regularly take prescribed medications, attend support group meetings, etc.

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* 11. Do you agree to keep the identities and shared experiences of other members confidential? For example, “what is shared here, stays here”.

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* 12. Are you familiar with the Stages of Change? If so, what stage would you consider yourself to be in (pre-contemplation, contemplation, preparation, action, and maintenance). If you aren’t familiar with this yet, don’t worry, just skip to the next question…

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* 13. Do you have an existing support system? For example, peer-support worker, mental health counsellor, doctor, family member, friend, sponsor, or someone else that you can trust and is supportive. Can you elaborate on these people a little bit?

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* 14. How did you hear about Path Found?

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* 15. What is the best way to contact you?

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* 16. Do you have a preferred pronoun? 

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* 17. Do you have any cultural considerations that you'd like us to be aware of?

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* 18. Do you have children? If so, do you need help paying or finding childcare services so that you can attend Path Found?

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* 19. Is there anything else you would like to tell us?

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