Advocacy Services Request
If you are in crisis and require immediate assistance, please call the Pierce County 24-hour Crisis and Information line at 1.800.346.7555.

If you'd like to request the services of a Rainbow Center Advocate, please complete the form below or email advocacy@rainbowcntr.org
Email address *
Your Preferred Name (first & last) *
Your answer
Phone Number
Your answer
Have you received RC Advocacy services before? *
First choice date request for this appointment: Appointments are only available Monday through Friday. *
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Alternative date request for this appointment: Appointments are only available Monday through Friday. *
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First choice time request for this appointment. Appointments are only available from 10am to 5pm. *
Time
:
Alternative time request for this appointment. Appointments are only available from 10am to 5pm. *
Time
:
Briefly describe the nature of the appointment *
Your answer
If you have any special requests (i.e. urgency of appointment, preference in meeting location, advocate, etc.), please provide details in the space below.
Your answer
Do you need a translator? If so, what language?
Your answer
Any other accessibility needs? If so, please describe.
Your answer
Additional Information:
Your answer
A copy of your responses will be emailed to the address you provided.
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