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Zip Code Entry
To help Hope Recovery document statistics, please enter your Zip Code the first time you visit. If you have visited before, please enter this one time only now.
What is your Zip Code (Do not add personal Information)?
What type of Trauma did you experience?
Assault with a weapon
Captivity (kidnapped, abducted, held hostage, POW)
Combat or exposure to a war zone
Exposure to toxic substances (dangerous chemicals, radiation)
Fire or explosion
Life-threatening illness or injury
Serious accident at work, home or during recreational activity
Serious injury, harm or death you caused to someone for which you accidently did
Sexual assault (rape, attempted rape, sexual abuse, any form of sexual act through force or threat of harm
Sudden unexpected death of someone close to you
Suddent violent death of someone close (homicide, suicide)
Transportation accident (MVA, train wreck, plain crash
Any other traumatic event or experience (miscarriage, etc.)
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