PSOT Referral Form
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.

We are only able to work with immigrants to the United States who are interested in applying for asylum or have already applied. 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). Please review our resource page 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 asylum related 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.

We will reach out to you directly within one to two weeks to follow-up. Thank you.

**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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