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 responsible reporter, completing this referral does not absolve you of your reporting responsibility. More on reporting responsibility.

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.