Safe Harbor Referral

Safe Harbor
Safe Harbor is a program that assists youth experiencing Commercial Sexual Exploitation. Sexual exploitation is when someone age 24 and under engages in commercial sexual activity. A commercial sexual activity is when anything of value or a promise of anything of value (e.g., money, drugs, food, shelter, rent, and so forth) is given to a person by any means in exchange for any type of sexual activity. A third party may or may not be involved.
Women's Advocates Referral Process
1. Review Women’s Advocates Program eligibility
2. Complete Referral Form
3. You will receive notification from our Safe Harbor Mobile Advocate upon receipt of referral form

Date*
MM slash DD slash YYYY
Reason for Referral:*
Participant Information
Legal Name*
First Last
Preferred Name
First Last
Date of Birth*
MM slash DD slash YYYY
Gender Identity:*
Pronouns
What language does the participant speak?*
Phone*
Email
Current Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Unhoused
- Participant is currently unhoused with no physical address.
Best contact method for client:
- Call
- Text
- Email
Referral Source
Please skip this section if you are self-referring.
Name
First Last
Organization
Title
Email
Phone
Best contact method for referral source:
- Call
- Text
- Email

Safe Harbor