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NJ Safe & Sound - NJ Safe and Sound

 



For Every Person, for Every Family —
Protection Under the Law from the
Psychological Abuse of Undue Influence and Predatory Alienation


Questionnaire B

— For those turned against their family

(If you are the parent, guardian, or relative of someone who has been or is now being alienated from your family, please answer Questionnaire A.)

(If you also know of an alienation outside your own family in which someone has been or is now being turned against his or her family by an external influence, please answer Questionnaire C.)

 

2. How old were you at first contact with the alienating influence?



 

3. Who tried to turn you against your family? (Choose all that apply.)

 

4. Did the alienating influence: (Choose all that apply.)

 

5. What kind of lifestyle changes did you make for the sake of the alienating influence? (Choose all that apply.)

 

6. What was done about the situation? (Choose all that apply.)

 

7. Which statement best describes the current status of your situation?





8. How old are you now?



9. How long did the alienation last/how long has it been going on?

10. May we contact you? If so, please enter your name and an email address or telephone number below:


 

 

 

 


 

"The family is the natural and fundamental group unit of society
and is entitled to protection by society and the State."

— Article 16.3, Universal Declaration of Human Rights of the United Nations

 

HomeLegislative Update | Petition | Letters to Legislators | Questionnaire

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