Refer a Client

HomeContact UsRefer a Client

We are currently accepting client referrals into our legal, economic empowerment, behavioral health and case management programs.

To refer a client, please submit this form.

Client Referral Form
Is the client aware that this referral is being made to the SAFE Center?
 

Referral Agency Information


First
Last
 

Client Information


Client Name
Client Name
First
Last
Client Gender:
Please make sure this is a safe number to call
Is Interpretation Needed?
Is the Client a Minor (Under the Age of 18)?

If the client is a minor, please fill out the following section 

Name of Parent/ Guardian
Name of Parent/ Guardian
First
Last
Is the parent/guardian involved?
: Has the case been reported to child protective services?
Is there a case worker assigned?
Case Worker Name
Case Worker Name
First
Last
 

Human Trafficking Case Information


Has the client disclosed their trafficking situation?
Type of Potential Trafficking:
Select all that apply
 

Client Needs


Please select client needs
Check this box if you prefer to discuss additional safety, legal and personal concerns on the phone
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Frequently Asked Questions

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We provide services to survivors of sex and/or labor trafficking of all ages, nationalities, and genders.
We are open from 9 a.m. to 5 p.m. on weekdays and will meet with clients on an alternative schedule on a case by case basis.

The exact address is confidential, but our office is located in Prince George’s County.

We do not currently operate a shelter or housing program, but we are able to connect clients to other organizations with housing programs while still providing them with other services at the SAFE Center.

Either complete the form about or call 301-314-7233.