Application to NCADV's Cosmetic and Reconstructive Support Program (CRS™)
NCADV's Cosmetic & Reconstructive Support Program (CRS™) was created to connect survivors of domestic violence to medical providers around the country. Services may be available at no charge to those in need of a provider to repair injuries inflicted by an abusive spouse or intimate partner. This process may take several months. Currently, NCADV assists survivors with the application process and assures all qualifications are met before submitting the application to a provider. If connected to a provider, it is your responsibility to inquire about additional charges that may be incurred (hospital, anesthesiologist, etc.).
APPLICANTS MUST MEET ALL THE FOLLOWING GUIDELINES TO QUALIFY FOR SERVICES
Physical injuries described must have been inflicted by an intimate partner or spouse. For example: husband, wife, boyfriend, girlfriend, someone that you dated or with whom you have a child. Other situations, while traumatic, unfortunately do not qualify. If the injury was caused by child abuse, elder abuse (if not an intimate partner), sibling abuse, caregiver abuse, parent abuse, violent attacks, stranger assault or accident not related to domestic violence, the application will be denied. Please know we are unable to assist those looking to have cosmetic surgeries repaired or amended, no matter the cause of initial injury.

Your safety is of the utmost importance. You must be out of the situation for at least six months. If not, the application may be denied. This is a requirement of our providers.

You must have had contact with a domestic violence advocate, social worker, case manager, counselor, faith leader, or therapist a minimum of (2) two times. You may contact the National Domestic Violence Hotline at 1-800-799-7233 to get the phone number of the nearest domestic violence agency or connect with your state coalition to find a domestic violence service provider (http://www.ncadv.org/need-help/state-coalitions).

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First and last name *
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Mailing address *
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City *
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State *
Zip code *
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Phone Number *
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Email address *
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Closest major city *
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Please note that travel may be required depending on the location of the provider.
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