Safe Way Out services are most effective when our clients participate in setting up the home security measures, learning security techniques, and attending our self-protection workshops. I understand that the more involved I am in the process and the more I take charge of my own safety the more effective this program will be for me. By clicking "I understand", I agree to make every effort to be involved with the security setup as well as attend the self-protection workshops when available. *

I understand

Name *

First Name

Last Name

Phone *

(###)

###

####

Is the offender in custody? *

Yes

No

Does the aggressor have access to weapons? *

Yes

No

Is there gang affiliation? *

Yes

No

Due to limited resources, we can only assist those who are in fear for their physical safety or the safety of their family. Are you in fear for your or your family's physical safety?

Yes

No