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StepAL.org Research Submission Form
Are you an Alabama resident?
*
Yes
No
In which County do you reside?
Autauga
Baldwin
Barbour
Bibb
Blount
Bullock
Butler
Calhoun
Chambers
Cherokee
Chilton
Choctaw
Clarke
Clay
Cleburne
Coffee
Colbert
Conecuh
Coosa
Covington
Crenshaw
Cullman
Dale
Dallas
DeKalb
Elmore
Escambia
Etowah
Fayette
Franklin
Geneva
Greene
Hale
Henry
Houston
Jackson
Jefferson
Lamar
Lauderdale
Lawrence
Lee
Limestone
Lowndes
Macon
Madison
Marengo
Marion
Marshall
Mobile
Monroe
Montgomery
Morgan
Perry
Pickens
Pike
Randolph
Russell
Shelby
St.Clair
Sumter
Talladega
Tallapoosa
Tuscaloosa
Walker
Washington
Wilcox
Winston
What is your role in the family?
StepMother
StepFather
Biological Mother
Biological Father
Have you and your current spouse been married for at least 24 months?
Yes
No
How many children currently reside in your home?
1
2
3
4
5
6
more than 6
Is there an active custody order in place?
Yes
No
How many minor stepchildren are involved in the reported conduct?
1
2
3
4+
Not Applicable
Is parenting time shared, primary, or sole?
Shared
No
Approximately when did the reported conduct first begin?
Before the marriage
During the first year of marriage
1–3 years after marriage
More than 3 years after marriage
Unsure
Has a stepparent in your household experienced any of the following? (Select all that apply.)
Physical assault
Threats of physical harm
Stalking (in person)
Stalking (electronic)
Harassing text messages
Harassing emails
Harassing phone calls/voicemails
Social media harassment
Photography or video of the residence through a minor
Photography or video of the residence through a third party
Unauthorized recording
Other invasion of privacy
False allegations
Interference with parenting time
False reports to DHR
False police reports
Interference with communication
Encouraging a child to spy or gather information
Coaching or influencing a child’s statements
What is the frequency of conduct being reported?
One occurrence
Occasionally
Monthly
Weekly
Multiple times per week
Daily
Ongoing
How long has the reported conduct occurred?
Less than 1 year
1-3 years
3-5 Years
More than 5 years
Who primarily engaged in the reported conduct?
Biological Mother
Biological Father
Other Family Member
Multiple Individuals
Other
Which of the following have resulted from the reported conduct? (Select all that apply.)
Emotional distress
Anxiety
Depression
Financial loss
Loss of employment
Marital strain
Counseling
Safety concerns
Relocation
Marriage Separation
Physical Harm
Damage to reputation
Financial cost of litigation
Increased attorney fees
Need for increased security measures
Other
What forms of documentation exist to evidence reported conduct? (select all that apply.)
Text messages
Email
Social media
Audio recordings
Video
Witnesses
Medical records
Police reports
Court filings
DHR records
Screenshots
Photographs
GPS/location records
Private investigator records
School records
Other
Have you (or your spouse) been advised to seek protection under the Alabama Protection from Abuse Act?
Yes
No
Has a police report been filed regarding any of the reported conduct?
Yes
No
Has the natural parent filed a Petition in Family Court or Domestic Relations Court to address the aforementioned acts?
Yes
No
Has DHR become involved in any manner since the date of your marriage?
Yes
No
What is the current status of the DHR investigation?
Pending
Indicated
Not Indicated
Administrative Review Requested
Appeal Pending
Unknown
Not Applicable
Has the reported conduct stopped?
Yes
No
Do you currently feel safe in your home?
Yes
No
If reported conduct has ceased, please note if it was the outcome of any of the following:
Charges filed
Petition dismissed
Protection order granted
Protection order denied
DHR unfounded
DHR indicated
Custody modified
Parenting plan modified
Other
Have there been factors that have helped improve your family’s situation? (Select all that apply.)
Counseling
Mediation
Improved communication
Court intervention
Family support
Time
Prayer
Other
Is there anything else you would like researchers to know about your experience? Please do not include names, addresses, case numbers, or any other personally identifying information in your response. (Optional)
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If you are human, leave this field blank.
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