Safe Door

If you are in immediate danger, call 911. This form is not a crisis hotline and may not be reviewed immediately. If someone may be monitoring your device, use a safer device or browser to access this page. Internet safety tips

Private Support and Referral Intake

Checkpoint Safe Door

This page exists so people have a safer first step. You do not have to be ready. You do not have to tell your whole story. You do not have to know what you need yet.

You do not have to report anything.

You do not have to agree to be interviewed.

You do not have to make anything public.

You may simply ask for support, resources, or help finding the safest next step.

Start Private Intake
What to expect

What Checkpoint Safe Door is, and what it is not

Some people arrive here because of a public conversation, documentary outreach, church situation, workplace concern, organization issue, family situation, or another harmful experience. Checkpoint does not assume what path you want to take.

This may help with

  • Support and resource navigation
  • Help finding local or national survivor support resources
  • Domestic violence support connection
  • Sexual violence support connection
  • Stalking, harassment, coercion, or retaliation support connection
  • Help thinking through safer next steps
  • Help understanding which door may be right for your situation
  • Consent-based referral to an advocate, organization, or reporting pathway

This is not

  • Law enforcement
  • An investigation
  • A public accusation platform
  • A documentary release form
  • A place to upload evidence or full allegations
  • A crisis hotline
  • A place that determines guilt or publishes accusations
  • A guarantee of immediate response

On outside referrals: Checkpoint will not share your information with an outside person, organization, journalist, filmmaker, media project, public platform, or reporting pathway unless you clearly request that referral, or unless a safety or legal reporting obligation applies.

Asking for support does not mean you are agreeing to be interviewed, recorded, named, quoted, published, reported, or connected to anyone outside Checkpoint.

Before you begin

Before you fill out this form

Please do not include graphic details, explicit images, evidence files, full allegations, or anything you are not ready to share in this first form.

You can simply say what kind of support or next step you are looking for. There is no pressure to share more than you are comfortable with at this stage.

Use a safer device if someone may be monitoring your phone, location, accounts, messages, browser history, or email.

You might say something like:
"I need resources near me."
"I want to know my options."
"I am not safe being contacted by phone."
"I want support but I am not ready to tell the full story."
"I want to be connected to the documentary contact."
"I want to know whether another reporting pathway is more appropriate."
"I am not sure what I need yet."
Private Intake

Support and Referral Intake Form

You may leave any field blank. Do not include graphic details, explicit images, or full allegations in this first form. You can simply tell us what kind of support or next step you are looking for.

Question 1 Name, nickname, or initials You may leave this blank if you prefer. You may also use a nickname, initials, or write anonymous.
Question 2 Safe contact method How can Checkpoint safely contact you? Select all that apply.
Contact information, if safe to share:
Question 3 Is it safe for Checkpoint to contact you?
Safe contact notes, optional:
Question 4 Where are you located? State only is okay. City and state are helpful if you want local resources.
Question 5 What are you asking Checkpoint for today? Choose anything that fits. You may select more than one.

If you are requesting connection to a documentary/storytelling contact: You may request to remain unnamed or use a nickname or initials. Checkpoint will not share your name or identifying contact information with a documentary/storytelling contact unless you clearly give permission.

You may also ask Checkpoint to pass along a basic non-identifying message first, so you can decide later whether you want direct contact.

Your documentary/storytelling connection preferences are collected in Question 9 below.

Question 6 Is there immediate danger right now?

If there is immediate danger, call 911 or emergency services in your area. This form is not monitored in real time.

Question 7 Does this involve a minor currently at risk?

If a child or vulnerable person may be in immediate danger, emergency or legally required safety steps may need to happen.

Question 8 Brief message Please do not include graphic details, explicit images, evidence files, or full allegations in this first form. You can simply tell us what kind of support or next step you are looking for.
Question 9 Consent for outside referral Checkpoint will not share your information with any outside person, organization, journalist, filmmaker, storytelling project, or reporting pathway unless you clearly request that referral, or unless a safety or legal reporting obligation applies.
If you selected documentary/storytelling connection above, please also indicate your preference here:
Question 10 Final acknowledgment

Your submission will be reviewed by a real person. Response times may vary. If you are in immediate danger, call 911. Your information will not be shared outside Checkpoint without your consent, except where a safety or legal obligation applies.

National support resources

24/7 Support Lines

RAINN National Sexual Assault Hotline

800-656-4673

24/7 support for survivors of sexual violence in the United States. Online chat also available at rainn.org.

National Domestic Violence Hotline

1-800-799-7233

24/7 support for people experiencing domestic violence in the United States. Text START to 88788.

Crisis Text Line

Text HOME to 741741

Free, 24/7 crisis support via text for people in the United States experiencing any kind of crisis.

If you are in immediate danger, call 911 or emergency services in your area. These hotlines and this form are not substitutes for emergency response.

Internet safety reminder. If someone may be monitoring your phone, location, accounts, messages, browser history, or email, use a safer device or private browsing window to access this page. Learn about internet safety

Submitting this form does not mean Checkpoint has verified anything. Checkpoint does not determine guilt, publish accusations, or investigate claims.

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