Refer Yourself or Someone Else

We're glad you're here and thinking about getting support. If you've been impacted by sexual violence (wherever and whenever it occurred) or a UA student has told you they've been impacted by sexual violence, filling out this form is a good idea. When you complete our referral form, a Survivor Advocate will contact you or the referred students via the preferred method of contact within 12 business hours.

If you're completing this form on behalf of a student survivor, we highly encourage you to let them know first. Please note that if you're a mandated reported, completing this referral does not absolve you of your mandated duty to report. More on mandated reporting.

Complete Our Referral Form

For disability accommodations, please contact us at 520-621-5767 or survivoradvocacy@arizona.edu 

Explore more survivor support hotlines and supportive resources.