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Forms

Request For Services

If you are interested in services, please use this link to submit your request. 

Self Defense Registration

Please use this form to register for our next self defense class.

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Referral Form

If you are a provider, please use this form to make a referral for SAHC services. 

Personal  Safety Order Forms

Click here for more information. If you would like a fillable copy of the petition, please email

info@sexualassaulthelpcenter.com. 

Client Survey

If you are a current or previous client, please share your experience with SAHC here. This information will only be shared with our Executive Director.

The information provided on this website is for informational purposes only and is based on the most current research and resources available at the time of publication. The views, findings, conclusions, and recommendations expressed are those of the author(s) and cited sources. They do not necessarily reflect the official positions or endorsements of any government agency, funding organization, the State of West Virginia, or any other affiliated entities. These entities do not operate, control, or assume responsibility for this website—its content, technical infrastructure, policies, or any tools and services offered.

All services are free and confidential.

The Sexual Assault Help Center does not discriminate on the basis of race, color, national origin, religion, disability and/or age in the delivery of services.

SAHC | A United Way Agency

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© 2025 by SAHC

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