Project DVORA Domestic Violence Services Contact Form

Thank you for connecting with Project DVORA at Jewish Family Service. If calling is safer, you can leave us a voicemail or reach an advocate on Tuesdays from 9 - 10 am or Wednesdays from 2 - 3 pm at (206) 861-3159.

What assistance are you seeking today?

I am 18 years old or older and seeking help.I am 13 to 17 years old and seeking help. I am 12 years old or younger and seeking help. I represent a Jewish organization seeking prevention or education workshops.None of the above

Please know that we can’t support clients with issues regarding parental/child abuse.

What support do you need? Please check ALL that apply.

I am experiencing intimate partner violence, abuse, or sexual assault.I need someone to talk to about a friend or family member who might be experiencing abuse in their relationship.I need legal support.I need financial assistance.I need shelter or other housing.I need other community resources (e.g., support group, food bank).I need mental health support.Other

Please Note: We do not have therapists at Jewish Family Service. We can help you look up therapy resources if mental health support is selected above.

We cannot provide direct services to youth under 18, but we can connect you with resources.

Please check ALL that apply.

I am or might be in an abusive relationship, and I need someone to talk to about my options and ways to increase safety.I need housing or shelter resources.I need legal resources.I need someone to talk to about a friend or family member who might be experiencing abuse in their relationship.Other

Other description

Please note: JFS does not have residential shelter services.

What type of legal support do you need?

Please know that we cannot guarantee legal services to all inquiries due to the high volume of requests.

What type of workshop are you interested in? Please check ALL that apply.

Youth prevention/healthy relationship workshop for high school or middle school age (one-off or a series)DV 101 presentationConsultation for your synagogue or community organizationOther

Other workshop description

Do you have tentative dates in mind?

YesNo

Desired date(s):

Unfortunately, due to Washington State law we can only directly serve youth aged 13+. Please reach out to: Friends of Youth, YouthCare or Roots for resources.

Please reach out to 211 for housing, financial assistance, and other resources.

First Name

Last Name

Synagogue or Organization Name

Pronouns

Current Zip Code

Phone Number

Is this a cell phone or home phone?

Cell phoneHome phone

Is it safe to call you?

Yes, detailed messages okayYes, generic messages onlyNo

Is it safe to call you?

Yes, detailed messages okayYes, generic messages onlyNo

Is it safe to text you?

YesNo

Is it safe to email you?

Yes, detailed emails okayYes, generic emails onlyNo

Email Address

How can we safely respond to your inquiry?

Have you been referred by a domestic violence advocate, healthcare/social service provider, etc.?

YesNo

Advocate Name

Advocate Phone Number

Advocate Email

Do you consent for us to contact this person for additional information about your case?

YesNo

Are you Jewish?

YesNo

Is anyone currently living at your address Jewish?

YesNo

Are you employed by a Jewish organization?

YesNo

Organization Name:

Do you have a connection to the local Jewish community? Please know that our services are confidential.

YesNo

Please briefly describe your connection to the Jewish community.

What else would you like us to know?

Please note: Please include either a phone number or an email address to ensure that we are able to contact you. For your safety, you will not receive an email confirmation upon submitting this form. Please allow 24-48 hours for a reply, not including holidays or weekends. If this is an emergency, we encourage you to call the 24/7 King County Hopeline at 206-737-0242.

Please note: Upon submitting this form, please allow up to five business days for a reply, not including holidays or weekends.

Created by Form Assembly

Project DVORA Domestic Violence Services

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