Alliance Referral Form Overview
We at NTSA are here to help you find residential services for recovery from trafficking or sexual exploitation. This form collects some basic information on your needs and preferences to better help us do that.
By completing this referral form, you are agreeing to allow the National Trafficking Sheltered Alliance to share this information with our referral system network of service providers, for the purpose of finding you appropriate services. This form must be filled out completely before submission. ALL INDIVIDUAL INFORMATION WILL BE KEPT CONFIDENTIAL within the Alliance network. You will be contacted directly by any agency that has availability and is able to consider you for placement. ARS will not replace the assessment process of individual agencies; we are a facilitator only.
We or our partners may publicly share aggregated information such as trends in survivors’ needs when doing so helps us advocate for survivors as a group. We will never publicly share information about individuals.
We commit to matching your referral to the appropriate residential programs in our system within 24 hours during business days.
We are not an emergency service, so if this is an emergency please contact 911 or the human trafficking hotline at 1(888) 373-7888.
As you begin...
This form can be filled out by yourself or by an advocate representing the individual needing services. Please answer all questions to the best of your ability, and indicate “Not Applicable” (N/A), or provide an alternative answer if necessary. Services are searched for according to the answers given below, so answering honestly will better help us find approproate matches.