Intake Form

The Initiative will be closed from December 16th 2024 through January 1st 2025. If you fill out an intake during this timeframe, an advocate will be in touch with you after January 2nd 2025. We appreciate your patience during this time. If you need immediate assistance please contact SafeHouse Denver or the National Domestic Violence Hotline at 1-800-799-7233.

All information that you submit through this online form is also protected by our confidentiality policy, and will only be seen by The Initiative’s advocates. If you mention child abuse in this form, we will have to report it. If you have any questions about our confidentiality policy, please contact us directly at 303-839-5510 or info@theinitiativeco.org and we can go over it together.

Please remember that we do not require answers to any of these questions! We ask these questions as a starting place for our advocates to get a sense of what’s going on and what resources might be available to help you. You can leave any of the questions blank. Some of these questions might be triggering, or hard to answer. Please take care of yourself as you fill out this form. We know how hard it can be to reach out for help – we appreciate you and your courage in starting this journey. 

At this time, we do not serve survivors who reside outside the state of Colorado. 

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