Quick Exit
In immediate danger? Call 911 24/7 Hotline: 1-800-799-7233 Text "START" to 88788
You're welcome here

Whenever you're ready. Even if "ready" is just curious.

Share as much or as little as feels safe. After the first two steps you can send what you have, and we'll reach back the way you choose. It all goes privately to our director. There is no wrong way to begin.

Safety first: If your device might be monitored, please use a trusted friend's phone or a public computer. If you need to leave suddenly, press the Quick Exit button (top right) or Shift + Esc, both will send you to a neutral search page and clear this page from your history.
How to clear a text conversation from your phone, when you're done

If you'd like to remove a text conversation from your phone (ours, or anyone else's), here's how. The image below is safe to save and share if it would help someone you know.

Step-by-step guide for clearing a text message thread on iPhone and Android

Welcome back. We kept your answers safe in this browser.
Step 1 of 5 · Safety

First, are you safe right now?

There are no right answers here. Pick what feels closest. You can change anything later.

If you are in immediate danger, please call 911 right now. You can come back to this form later.

We will never leave a voicemail or identify ourselves unless you tell us it's safe to.

If you can share more, the next two questions help us prepare to support you safely. Skip either if you'd rather not say.

Please don't put yourself at risk to finish this form. You can submit what you have so far and we'll reach back safely.

We ask this because the presence of weapons can change how we plan to safely reach you and meet you. Your answer stays private to our staff.

Step 2 of 5 · You

A little about you.

Just a first name and one safe way to reach you is enough. Everything else helps us prepare, but skip whatever feels too soon.

Even a name you only use here is fine.

A number where it's safe for us to reach you.

These next questions help our staff prepare for your call. All optional.

Short on time or privacy?

Send what you have now. Sending means you're okay with us reaching out the way you chose above.

Step 3 of 5 · Home

Your household.

We do everything we can to keep families, including pets, together. You're not asking for too much.

Don't worry if you have nothing. We will help you replace what you need.

Step 4 of 5 · Needs

What kind of support are you looking for?

Check anything that might help. There are no wrong answers. We'll work through it with you.

This helps our team prepare before we call you back. If nothing fits, leave it blank.

A few practical questions. These help us prepare the right kind of support before we call. All of these are optional. Skip whatever you'd rather discuss in person.

Helps us check what benefits you might qualify for. No proof needed at this stage.

We won't make you reapply for anything you already have. This just tells us where to focus.

If not, that's usually our first step together. We can help.

Step 5 of 5 · Story

Anything else you'd like us to know?

You can leave this empty. We'd rather hear nothing here than have you share more than feels safe.

Skip this if you'd rather talk in person or over the phone.

Not a survivor, but want to talk to us about something else? Use the contact page instead →