The Binaytara Foundation is establishing home hospice services in Nepal. We would like to learn about your experience with end of life care in Nepal.
Talk about a time when someone you know was dying. Who cared for them? How could they have been helped?
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Name the organization or group most involved in what happened.
Where did this story take place? (country)
Where did this story take place? (city or district)
Where did this story take place? (village, neighborhood, or street)
Your gender:
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Your age:
What is your connection to what happened in the story?
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Who benefitted from what happened in the story?
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Storyteller's phone number / email address:
We never give out your number or email to anyone.
May we contact the storyteller by SMS?
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Scribe's phone number / email address:
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Other information:
Anything else you want us to know
This story makes me feel:
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Events like those in my story happen…
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Rarely
Often
 
The events of your story affect…
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What is needed to address the problems in your story?
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Who would you go to if you wanted to solve the problem in this story?
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What else would have made a difference in your story?
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