Whitfield st.

We are currently gathering evidence for a buffer zone around the Central London Marie Stopes Clinic on Whitfield Street and first-hand accounts are the best way of demonstrating the traumatic effects of clinic 'vigils'.

If you have witnessed any harassment outside this clinic at any point, no matter how long ago, please report it to us using the form below. If you would rather remain anonymous, please use the name Jane Doe.

Please let us know if you are happy for us to contact you via e-mail for a formal statement by ticking the box at the bottom of the form.

If you have any questions please contact us on contact@sistersupporter.co.uk.

Thank you.

Name

First Name

Last Name

Email

Please describe your experience

Please describe the impact on you from this experience, whether physical, emotional or psychological i.e. Did you feel or act differently the following hour/day/week/year after your experience? Are you still affected by the experience now and in what way?

When did your experience happen?

(actual date if known, or approximate date)

Did you call the police about your experience?

If yes, what was the outcome? Do you have a police reference?

If no, why?

Can SisterSupporter contact you via e-mail for a statement?

*Please note we will only contact you if you give consent and we won't share your info with anyone.

Yes

No

Whitfield st.

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