Self - Referral
Self Referral Form
Somewhere To Go Foundation is a not-for-profit that offers a support base for women dealing with domestic violence and abuse. We provide emotional and practical support along with strategies to help women access and understand the services available to them.
Somewhere To Go Foundation has an unpublicised location, and we ask that you help us keep the location private.
What is this form?
We invite you to complete this form to help us know more about your personal circumstances, and how we can help.
Some of the questions may be hard to answer, and all questions are optional – you may provide as little or as much information as you like.
Why do we have this form?
✓ To provide appropriate and relevant support for you.
✓ To know more about the kind of community education and training that we could provide.
Information we collect, use and store.
We ensure that all information we collect about you is used only in relation to you and your specific circumstances. We ensure this data is stored securely and we do not share your information with any third parties. If we are required to share details about, we will only share single pieces of information not collective information that could be used to identify or disclose your personal circumstances.
Data Security
Somewhere To Go Foundation strives to ensure security, integrity, and privacy of your personal information. We regularly review and update security measures in relation to current and future technologies and data storage and security.
Systems and procedures are in place to protect your personal information from misuse, loss and from unauthorized access, modification or disclosure. Somewhere To Go Foundation will retain information in line with its record retention policies.
When information is no longer required or relevant it will be disposed of in a secure manner.
Anonymity
Where lawful and practicable, Somewhere To Go Foundation allows people to participate in activities anonymously (e.g. when
completing evaluation form, surveys or meetings).
Further Questions:
If you have any questions about our privacy policy, please contact us on
[INSERT EMAIL ADDRESS - this should be admin@; info@; hello@}
Please complete this form and we will be in contact with you.