Enquiry form: Survivors, family and friends

Before you begin

Before you begin completing this online form please note we are happy to answer any questions you may have however, we do not provide a crisis service. If you wish to seek emotional support you can contact our helpline whose opening hours are here. If you are in immediate danger, please dial 999.

Self-referring means you can contact us directly to access support.

SARSVL can provide a safe space for you to talk about how rape or sexual violence has affected you and we can help you to explore your options. We offer a specialist counselling service; advocacy and court support through our ISVA service; and emotional support by phone, text or email through our Helpline service. This form is for the ISVA service only.

Independent Sexual Violence Advocate


Our ISVAs are trained in providing specialist trauma informed emotional support to help women throughout the life of a police investigation and beyond if the case gets to court. Emotional and practical support is available for women who wish to explore reporting to the police or have already done so.

At SARSVL we have ISVA’s who support women aged 18 and over, and a specialist Young Person’s ISVA who supports young women aged between 13 to 24.

We offer appointments to suit your needs - they can be face to face in our Leeds Office, online, or over the phone. For young women aged between 13 and 17 we can offer outreach appointments such as in your school or college.


Female 13 years and over resident in the Leeds area.

Once we have received your details from this form, we will contact you within 3 workings days, to obtain more information in order to process your referral.

SARSVL aims to offer a confidential service. Your data is stored in accordance with GDPR regulations and will be destroyed after 7 years. However, if we are concerned about your welfare, or the welfare of others, then we may need to share information with appropriate external agencies. Please tick the box below to give your consent for us to keep this data.

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Main Details

Client Contact Details

Additional Details

If you are completing this form on behalf of someone else, please provide your name and relationship to the person being referred in the comments box below. Please note we can only accept this referral if the person being referred is aware and consents to the referral being made.

Please tick box below to show consent given for referral to support services*