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.

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

Criteria:Female 16 years and over resident in the Leeds area. Appointments are held at out central Leeds office. We can offer outreach appointments (ie in schools/colleges) to 16 and 17 year olds.

About: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.


SARSVL’s Office Coordinator will then make initial contact with you within 3 working days to arrange an assessment by phone if you are aged 18 and over, or a face to face assessment if you are aged 16-17. Three attempts will be made to contact you. Please make sure your preferred contact details are correct.

You do not need to complete a referral form to access the Helpline Services; please check supportafterrapeleeds.org.uk for up to date opening times.

SARSVL uses the information you give us for monitoring and reporting purposes. We keep your information securely stored in our office and on a secure encrypted database; we do not share information with anyone else unless we are concerned about a safeguarding issue such as risk to you and/or others or risk to a child. SARSVL will keep your information for 7 years after your case has closed; after that time your information will be destroyed confidentially.

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Main Details

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Service Details

Client Contact Details

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Additional Details

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Are you are completing this form on behalf of someone else, if yes please provide your name and relationship to the above named person; in the comments box below. (Please note we can only accept this enquiry if the named person on this form is aware).

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