Your privacy matters to us.
The Survivor Referral Form is voluntary. You choose what to share. You can also reach us by phone at 833-5-BESAFE if you would rather talk with someone than fill out a form.
Who will see this information. Your responses go directly and only to Safe House Project’s survivor support team, the trained staff who respond to referrals. Access is limited to staff directly involved in providing support, all of whom are background checked and sign confidentiality agreements.
How it will be used. We use what you share for one purpose: to understand the situation, assess safety, and connect the survivor with services. We will not share your information with anyone outside Safe House Project, including law enforcement, without the survivor’s specific written permission, unless we are required by law to report (for example, suspected abuse of a child or a life-threatening ). Receiving services never requires participation with law enforcement.
How it is stored. Your information is kept in a secure, access-controlled database and is encrypted both when it is sent and where it is stored. Records are retained for five years and then anonymized.
Your choices. You may contact us at any time to ask questions about your information or to request that it be updated or deleted, by calling 833-5-BESAFE or emailing info@safehouseproject.org.
If you are referring someone else, please share only what you know and what is needed for us to respond. We will treat their information with the same care described here.
© 2026 Safe House Project.