PSOT Referral Form
PLEASE REVIEW OUR ELIGIBILITY GUIDELINES BEFORE COMPLETING THIS FORM.
https://www.survivorsoftorture.org/for-survivors 

The Bellevue Program for Survivors of Torture (PSOT) is currently accepting referrals for new clients.  We have a short waiting list, and applicants can expect a delay of several weeks in between their first contact with us and an intake interview with one of our Program therapists.

At this time, we are only able to work with adults residing in our catchment area (New York City - Brooklyn, Bronx, Queens, Staten Island, Manhattan - and New York State). We can also only work with people over the age of 18. New Jersey residents are also eligible, but due to State Licensure Requirements, they must receive all services on-site.

Please review our resources for out-of-state referrals.  Our treatment program provides medical, mental health, legal, and social services to our clients.  This includes specialized individual and group therapy and psychiatry, as well as expert guidance through the asylum process, help to find a lawyer, and assistance getting connected with a medical doctor and medical insurance.

You may complete our referral form to indicate your interest in becoming a client, or to refer another individual.   Please allow one to two weeks for someone from our team to reach out to the interested party directly.  Please note that if we are not able to reach you after two telephonic attempts, the referral will no longer remain active.  We encourage you to re-refer at any point in the future should your needs remain unresolved.  You are also welcome to reach out to us directly via email at info@survivorsoftorture.org.

For the purposes of this form and your confidentiality, at this time we do not need extensive information about your asylum application.  Please answer as many of the following questions as possible.

PLEASE NOTE: Unfortunately, our capacity for new client intakes is currently limited; our next available appointments are in 2023. Despite this, we encourage all eligible prospective clients to fill out this form and we will get back to you at our soonest availability. We hope that in the coming months we will fill new positions that will allow us to attend to your needs in a more timely manner.

**If you are currently experiencing a crisis, please call NYC WELL (888-692-9355) to be connected with a counselor. NYC-WELL is available 24/7.

**If you are in an emergency, please call 911 or visit your nearest emergency room.
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