Asscessment Form

Are you fearful for your life and Security being Muslim?

Yes No

Has your life being threatened in India because of your religion?

Yes No

Do you know any other Muslim whose life is also threatened?

Yes No

Have you ever been attacked, Tortured, Humiliated, or any other family members, for being Muslim?

Yes No

Have you faced any persecution in Employment, Housing, Healthcare for being Muslim, have your children faced any persecution in the education system?

Yes No

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