Share what happened

You can take your time.
You are in control of what you share.

This intake is independent, confidential, and not connected to any institution.
You may remain anonymous.

Step 1 of 7

Section 1 · Context

What system or service was involved? *

State *

City or county

Approximate date

Section 2 · What happened

Tell us what happened * Share as much or as little as you want. You can describe what happened, what concerned you, how it affected your family, and anything you believe was inaccurate or unfair.

Section 3 · Response

Did you try to raise this concern with the institution? *

Yes No Not sure

Section 4 · Record concerns

Do you believe the official record misrepresented your family? *

Yes No Not sure

Section 5 · Documentation

Do you have documentation related to this experience?

Emails Court records Medical records School documents Caseworker notes Personal notes or timeline Other documents No documentation

Document label 1 Optional

Upload file 1 Optional · One file up to 8 MB

Document label 2 Optional

Upload file 2 Optional · One file up to 8 MB

Document label 3 Optional

Upload file 3 Optional · One file up to 8 MB

Section 6 · Optional follow-up

Would you like Change Collective KY to contact you if more information is needed? *

Yes No

Section 7 · Before you submit

I understand this may be used to identify patterns across families. I understand any public reporting will not include identifying information. I understand this does not create a legal or advocacy relationship.

Important to know

This form is designed to document experiences and understand patterns across systems. It is not a complaint process and does not replace legal advice, emergency help, or crisis support.

Thank you for sharing what happened.

Your experience matters. When families share what they have been through, it helps make patterns visible and pushes systems to do better.