EVOLVE Participant Abuse Report Form
This form is for those who wish to to report potential abuse within the EVOLVE. We encourage all Participants / Parents / Support Providers to communicate with the program staff directly, via email, or phone.

Please note that this action is not in response to anything, just a proactive way to ensure that lines of communication are open and that there exists a way to report incidents and maintain anonymity. Should you have any questions please feel free to contact us at 209-482-4483 or via email at report.abuse@widehorizons4u.org.

Wide Horizons, Inc. and its E.V.O.L.V.E. Program are committed to providing a safe and supportive environment for all participants. We believe that abuse prevention is everyone's responsibility, and we encourage everyone involved in our program to be vigilant and report any suspected abuse.

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Your name (optional)
Name of Participant experiencing abuse *
Name of suspected abuser *
Relationship of suspected abuser to Participant *
Type of Abuse *
Names of any witnesses
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