Thank you for reaching out to 8994 Foundation. This intake form is designed to help us better understand your needs and explore how we can offer support to you and your child who has experienced the loss of a parent to violence. Please fill out the following details, and rest assured, your information is treated with the utmost confidentiality.
This form serves as an initial point of contact to gather essential information about your situation. Our goal is to assess how we can provide assistance and resources tailored to the unique needs of your family during this challenging time.
Confidentiality Notice:
We understand the sensitive nature of the information you are sharing. Rest assured that all details provided will be kept confidential within 8994 Foundation. Exceptions to this confidentiality may occur if there is a disclosure of imminent harm to yourself or others. In such cases, we are obligated to take appropriate measures to ensure safety.
Purpose of Reporting Harm to Self or Others:
Your safety and the safety of those around you are of utmost importance to us. If you disclose any intentions of self-harm or harm to others, we are obligated to report this information to ensure the necessary support and intervention are provided. We are here to assist you and connect you with the help you need.
Support and Resources:
By completing this form, you are taking the first step towards healing. Our team will review the information provided, and a member of 8994 Foundation will reach out to discuss potential avenues of support and resources that may be available to you and your child.
