For Survivors

We are a resource and referral center and help connect people to registered agencies and then offer further assistance via their case workers.
If you need help and don’t know where to turn, please fill out the form below and we will respond in a timely manner to see if and how we can offer assistance.
Please note: if you do not supply proper contact info of some kind, we will not be able to get in touch with you.

Request for Assistance

    If you are not comfortable giving your real name at this point, please give us a name to address you by.


    (All we need is a general idea so we are better prepared to respond.)