Islington Survivors Network

Survivors Contact Form

(This form should also be used by those who were child witnesses to abuse even if they themselves were not abused.)

Your information will help us build a picture of what happened to children in Islington’s care from the 1950s onwards.

We ask for your phone number and email as we might wish to speak with you. We would contact you first by email before calling you.

All contact will be received in confidence. Please be aware that from any information given, if it is clear that children or adults are currently at risk of harm, we are duty bound to report to the appropriate authorities. We will work with you should you wish to make a report to the authorities.

Should you have any questions please email us at: islingtonsn@gmail.com

Current Name

Name when in care

Date of Birth

Your Email

Phone

Are you? (please select)

As a survivor, what type of abuse did you experience? (please tick all that apply)

SexualPhysicalEmotionalNeglect

As a witness, what type of abuse did you see? (please tick all that apply)

SexualPhysicalEmotionalNeglect

Were you a child placed in an Islington Childrens’ Home?
YN

Which childrens’ home(s) were you in? (please tick all that apply):

Were you placed in Foster Care or Adopted through Islington Council? YN

Please confirm which?

Please provide details, with names and dates.

Did you have brothers/sisters also placed in care/fostered/adopted through Islington
Council?

Please provide details with dates.

Please provide the names of Care home staff/Managers and/or other adults directly connected to your care through Islington Council? Please include dates.

If you are a survivor of abuse, while under the care of Islington Council, did you ever report your abuse/abuser(s).

If you reported your abuse/abuser(s) who did you report to? (please tick all that apply)

Please enter details here:

What was the outcome? Please provide details and dates.

Please provide any other information about what happened to you, while in the care of Islington Council, which you would like us to know about.