If you need immediate help or are in danger, call the Human Trafficking Hotline: 888-373-7888

Change Starts Here

Do you want help from Dorothy’s House to begin your healing journey? Are you ready to make long-term positive changes to your life? Complete this intake form.

Note:  Dorothy’s House reviews all applicants within 24 hours in consideration of services and support. The more information you can provide, the better we can evaluate how to help.

Intake Form
MM/DD/YYYY
Do you have a valid ID?

Help us get to understand your circumstances.

Are you safe?
Are you currently homeless?
Is anyone controlling you, or your money?
What is your marital status?
Do you have custody of minor children?
Do you have access to your own transportation?

Caseworker/Advocate

Do you have a caseworker/advocate?
Consent

Help us know how to serve your needs.

Are you currently abusing, or have you ever abused, alcohol or drugs? Check all that apply:
Are you now, or have you ever been, in a gang?
Do you have a criminal record?
Please check all that apply:
Do you have any income currently?
Do you have healthcare insurance/Medicaid?
How would you rate your health overall?
Do you smoke cigarettes?
What mental health diagnosis have you received?
Do you currently self-harm, or have you in the past?
Do you have a history of violence towards others?
Are you receiving/have you received treatment in the last 12 months?

How can we help you most?

Other Organizations

BRAKING TRAFFIK (FAMILY RESOURCES)

Braking Traffik provides comprehensive, trauma-informed services to victims of sex and labor trafficking, including: housing, counseling, medical and court advocacy, and resources and referrals. Their mobile advocates meet survivors where they are. This organization also offers training and public awareness. Located in Davenport.

Service Area: Clinton, Jackson, Louisa, Muscatine, and Scott counties

Crisis line: 1.866.921.3354

http://famres.org

CATHOLIC CHARITIES

Catholic Charities provides legal and medical advocacy, crisis counseling, groups and classes, safety planning, housing and economic advocacy and shelter. Located in Council Bluffs.

Service Area: Audubon, Cass, Fremont, Harrison, Mills, Montgomery, Page, Pottawattamie, and Shelby counties

Crisis line: 1.888.612.0266

http://www.catholiccharitiesdm.org/our-services/domestic-violence-shelter/

CHAINS INTERRUPTED

Chains Interrupted provides transitional housing for survivors of sex trafficking. Services for participants in the housing program include sliding-scale rent, assistance with daily living expenses and survivor advocacy like referrals, help obtaining further education and employment, medical care, childcare and legal services. The organization also provides survivor-led support group to survivors of sex or labor trafficking. Located in Cedar Rapids.

Service Area: Benton, Black Hawk, Buchanan, Cedar, Iowa, Johnson, Jones, Linn, and Washington counties

Emergency line: 1.319.536.2027

Non-emergency line: 1.319.369.4415

http://www.chainsinterrupted.com

FRIENDS OF THE FAMILY

Friends of the Family provides comprehensive, trauma-informed services to victims of sex and labor trafficking including relocation; safety planning; shelter; counseling; medical, legal and general advocacy; resources and referrals; crisis intervention; and support groups. Their mobile advocates meet survivors where they are. This organization also offers training and public awareness. Located in Waverly.

Service Area: Allamakee, Benton, Black Hawk, Bremer, Buchanan, Chickasaw, Clayton, Delaware, Dubuque, Fayette, Howard, Jones, Linn, and Winneshiek counties

Crisis line: 1.800.410.7233

http://fofia.org