HTTF Point of Contact Form
The Task Force serves to implement the continuum of care to address human trafficking in the Tri-County area.
Toward this end, this form serves as our consistent records intake.
Please take 2-3 minutes to complete the form.
Please understand your information will be shared with Task Force Leadership.
For any questions, email Brooke Burris at:
bburris@tricountyhttf.org
* Required
Date
MM
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DD
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YYYY
Agency Name
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Your answer
Agency Website
Your answer
Agency Phone
Your answer
Primary Agency Address
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Your answer
Name (First Last)
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Your answer
Title/Position
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Your answer
Email
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Your answer
Phone (primary, secondary)
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Your answer
Jurisdiction(s) in which you serve
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Your answer
Task Force Subcommittee
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Awareness/Prevention
Research & Data
Law Enforcement
Legal Innovations
Child Services
Adult Services
Healthcare
Community & Faith-Based
General Listserve
HT Continuum of Care Response (created by the S.C. Attorney General)
Which aspects of the Continuum of Care are relevant to your role? (check all that apply)
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Identify the Incident/Victim (i.e., screening and referrals, mandated reporters)
Rapid Response (i.e., crisis coordination)
Acute Care (i.e., intake, safety planning, shelter, crisis medical care/exams)
Court and Legal Procedures (i.e., criminal and civil legal systems, access to justice, legislation)
Housing (i.e., transitional and long term housing, foster care, restorative care)
Transition Support (i.e., rental / documentation / benefits assistance)
Community Based Services (i.e., specialized or general ongoing support)
Other (specify your role below)
Required
Other Role(s)
Your answer
What services does your organization provide?
Your answer
Hours services are available?
Your answer
How are services accessed?
Your answer
Professional Category (choose best option)
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Choose
Social Services
School System
Child Advocacy
Substance Abuse
Mental Health
Medical / Dental
Domestic Violence
Sexual Assault / Rape Crisis
Homelessness
Lay Guardian Ad Litem
Attorney Guardian Ad Litem
Juvenile Justice
Judicial
Investigations
Attorney
Employment / Financial Assistance
Faith-Based
Other (please specify below)
If other or more than 1 professional category, please specify:
Your answer
What you can do!
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Serve as a Point of Contact for the Continuum of Care Response
Attend Subcommittee and Task Force Meetings as practicable
Donate/Volunteer (specify below)
Other:
Required
Volunteer/Donate/Other? (please list below what you can volunteer/donate/other to support survivors and Task Force Members - be as specific as possible: your time, your skillset, type of law you practice, funds, type of therapy you provide, etc.)
Your answer
THANK YOU! This information is enormously helpful! Thank you for what you do and for your heart for this issue! Please add any comments / feedback below:
Your answer
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