NCVSP: Make Sure You are Counted in 2023!

In preparation for the census, we are identifying as many victim service providers as possible. This way, we can begin with the most inclusive and updated provider list available ahead of sending out the questionnaire.

If you are willing to support us in this process, please take a few minutes to leave your victim assistance program's contact information using the form below. If you have any questions, please contact Susan Howley at SHowley@jrsa.org. Thank you!

A "Victim Service Provider" is any program or organization that directly provides services to victims of crime or abuse. We want to hear from all providers! Please leave your information below if your program or organization meets this definition.

Question Title

* 1. Point of Contact

Name

Email Address

Phone Number

Question Title

* 2. Victim Assistance Provider Contact Information

Organization/ Agency *

Specific Program Name

Address *

Address 2 *

City/Town *

State/Province *

ZIP/Postal Code *

Program Email

Office Phone Number *

Question Title

* 3. Any additional information you think we should know?

By submitting this form, you are providing your contact information and consenting to being contacted about the NCVSP.

Any information you provide will only be used for statistical purposes during the study and in ways that will not reveal names of individual organizations or personal contact information.