Ask for ANI report

Domestic abuse response in pharmacies monitoring form

The Home Office would like to understand how the 'Ask for ANI' scheme is being used, by whom and in what context to inform its future development. We also want to understand how it sits alongside Safe Spaces, which many pharmacies are also offering. We have therefore designed the following light-touch monitoring form for participating pharmacies to complete immediately after an individual who has sought help due to domestic abuse leaves the relevant premises. Please do not write your name or the name of the individual using the code word anywhere on the form to ensure the use of the code word remains anonymous and confidential. 

Ipsos MORI (an independent market research company) has been contracted by the Home Office to evaluate the 'Ask for ANI' scheme. The Home Office will send the anonymous data to Ipsos MORI, who will process the information as part of the evaluation. Data will also be shared with Hestia, the charity that supports that Safe Spaces initiative.

Thank you in advance for your cooperation. Should you have any questions, please contact the Home Office at