GBVIMS: Gender-Based Violence Information Management System

  • About the GBVIMS
    • GBVIMS and Primero/GBVIMS+ Monitoring and Evaluations
    • GBVIMS Background
    • Purpose
    • Learn About the GBVIMS
    • Where is the GBVIMS?
    • Who is the GBVIMS Global Team?
    • Frequently Asked Questions
    • GBVIMS Donors and Supporters
  • GBVIMS Basic Tools
    • GBV Classification Tool
    • Intake and Consent Forms
    • Incident Recorder
    • GBV Information Sharing Protocol Template
    • User Guide
  • Primero/GBVIMS+
    • Introducing Primero
  • Implementation
    • GBV Case Management
    • Rollout Guidelines
    • Facilitator’s Guide
    • Data Analysis
    • Data Analysis E-Learning Tool
    • Technical Support
    • Data Protection
  • Learn More
    • Access the GBVIMS
    • GBVIMS Incident Data: Analysis and Advocacy
    • Guidance Notes
    • Linking Data Analysis to Programming
    • Video Shorts
    • Podcast
    • Additional Resources
  • Resources
  • COVID-19
    • Guidance Notes for GBVIMS, GBVIMS+ and Case Management during COVID-19
    • Podcast and Video Series: Remote GBV Case Management

Intake and Consent Forms

Currently, most organizations collecting GBV information determine individually and independently what data they will be collecting from survivors and how to define that data.  Consequently, the format, content and quality of the resulting GBV data varies greatly from one organization to another.  This makes compiling data from different service providers and then effectively analyzing that data extremely difficult.

The Intake and Initial Assessment Form is an easy-to-use, customizable template to be used by individuals interviewing GBV survivors reporting an incident.  It is designed to collect a standard set of meaningful GBV indicators across all service providers while reducing variation in how data is collected.  The intake form is comprised of six sections, each section containing fields collecting relevant and important information:

  • Administrative Information
  • Survivor Information
  • Details of the Incident
  • Alleged Perpetrator Information
  • Planned Action/Action Taken
  • Assessment Point

The Consent for Release of Information Form is a form requiring survivors to give their authorization for any of their information to be shared with other agencies or organizations.  It is intended to ensure that the rights of the survivors to control their incident data are maintained and protected.

Download consent form [English – pdf | ms word] [Français] [Español] [عربية]
Download standard intake form [English] [Français] [Español] [عربية]
Download basic 2-page intake form [English] [Français] [عربية]
Download health practitioner intake form [English] [Français] [عربية]
Download acute emergencies intake form [English] [عربية]

GBV Case Management Capacity Building Initiative Announcement: Strategy and Toolkit Now Out!

Following the 2017 publication of the Interagency GBV Case Management Guidelines, the GBVIMS Global Team invested in a capacity-building initiative to operationalize the guidelines: the GBV Case Management Capacity Building Initiative (GBV CM CBI). In 2017-2018, pilot projects were implemented in Bangladesh, Mali, Nigeria and Somalia to finalize and test the approach of the GBV […]

GBVIMS and COVID-19 Announcement: Remote GBV Case Management series in the COVID-19 response

NOW IN AVAILABLE IN FRENCH The GBVIMS Steering Committee has put together a series of video shorts and podcasts on remote GBV case management in the context of the COVID-19 response. The series is aimed at supporting GBV caseworkers and supervisors to adapt their service provision in the context of governmental policies imposed in response […]

Primero/GBVIMS+ Periodic Review OUT NOW!

Check out the first ever Primero/GBVIMS+ Periodic Review (Libya, Bangladesh, Lebanon and Nigeria rollouts) here!

EMAIL: gbvims@gmail.com [en & fr]

SKYPE: gbvimshelp [en] • gbvimsaide [fr]

Copyright © 2021 GBVIMS: Gender-Based Violence Information Management System

  • About the GBVIMS
    • GBVIMS and Primero/GBVIMS+ Monitoring and Evaluations
    • GBVIMS Background
    • Purpose
    • Learn About the GBVIMS
    • Where is the GBVIMS?
    • Who is the GBVIMS Global Team?
    • Frequently Asked Questions
    • GBVIMS Donors and Supporters
  • GBVIMS Basic Tools
    • GBV Classification Tool
    • Intake and Consent Forms
    • Incident Recorder
    • GBV Information Sharing Protocol Template
    • User Guide
  • Primero/GBVIMS+
    • Introducing Primero
  • Implementation
    • GBV Case Management
    • Rollout Guidelines
    • Facilitator’s Guide
    • Data Analysis
    • Data Analysis E-Learning Tool
    • Technical Support
    • Data Protection
  • Learn More
    • Access the GBVIMS
    • GBVIMS Incident Data: Analysis and Advocacy
    • Guidance Notes
    • Linking Data Analysis to Programming
    • Video Shorts
    • Podcast
    • Additional Resources
  • Resources
  • COVID-19
    • Guidance Notes for GBVIMS, GBVIMS+ and Case Management during COVID-19
    • Podcast and Video Series: Remote GBV Case Management