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SWCSL Resource or Offer of Assistance
This form is to communicate a new resource, an offer of assistance, or amendment/ update to an existing contact or resource. Please start by noting YOUR email in the field below.
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Email
*
Your email
Date of Call
MM
/
DD
/
YYYY
Time of Call
Time
:
AM
PM
How Did They Contact US?
Community Support Line Phone
Community Support Line Chat
Social Media or Other SWOP Chapter or Website
Other:
Name of Individual
*
Your answer
Organization
*
Your answer
Contact/Organization Email
Your answer
Phone
Your answer
Caller City
Your answer
Caller State
Your answer
Caller Identity - Check All That Apply
Service Provider - legal
Research/ Academic
Politician/ Elected Official/ Government Rep
Ally or Friend/Family of a SW or Human Trafficking Victim/ Survivor
Prison/ Jail Facility
Service Provider (Outreach Worker)
Anonymous/ Unknown
Trafficking Victim/ Survivor
Donor
Service Provider (Therapist or Social Worker)
Probation or Parole
Minor/ Underage Person
Activist/ Advocate
Service Provider (Medical)
Current/ Former Sex Worker
Volunteer
Other:
How did the caller hear about us?
Adult Advertising or Safety Platform
SWCSL Website or other SWOP Chapter or Allied Org Website
Polaris Hotline
Attorney Referral
Peer Referral
Blog/ Newsletter/ Podcast
News Article or Media
Google or Other Search Engine
Case Manager/ Social Services
Other:
Assistance Offer
Bail
Clothing
Crisis Counseling
Education
Peer Support
Exit Program/ Support
Food
Harm Reduction Supplies/ Substance Use Disorder Support
HIV/ Hep C/ STI Resources and Testing
Housing (Emergency)
Volunteer Labor
Mental Health Support
Mutual Aid (Funds)
General HealthCare
Reentry Resources/ Programs
Training
Legal Resource
Chat Transcript - Copy/ Paste Directly From Chat Dashboard
Your answer
Call Notes - Log Your Phone Notes
Your answer
Request Follow Up
Yes, by phone
Yes, by email
Unknown
No
Add to newsletter
Other:
A copy of your responses will be emailed to the address you provided.
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