Domestic Violence Support + Education for Survivor

Referral Instructions

Please complete the referral form below to request enrollment in the Domestic Violence Survivors Program. This eight week, trauma informed course is designed to support women who have experienced domestic abuse and are seeking healing, education, and a supportive community.

The program provides a safe and confidential space for participants to rebuild confidence, develop personal safety plans, and strengthen skills in communication, boundary setting, emotional regulation, and self advocacy. Services are grounded in compassion, dignity, and respect for each participant’s lived experience.

Once the referral form is submitted, our team will review the information and follow up to discuss next steps, scheduling, and participation details. All information shared is kept confidential and handled with care. If there are immediate safety concerns or specific accommodations needed, please note this in the additional notes section.

If you have questions or need assistance completing the referral form, please contact our office for support.

Domestic Violence Education For Survivors

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Personal Information

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Consent + Agreement

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