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Get the free Request for Escaping Violence Status - Region of Waterloo

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COMMUNITY HOUSING ACCESS Center (CHAT) 235 King Street East, 6th Floor, Kitchener, ON N2G 4N5 Phone: (519) 5754400 Fax: (519) 8938648 CHAT Email (chat×regionofwaterloo.ca) CHAT Website (www.regionofwaterloo.ca/chac) REQUEST
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How to fill out request for escaping violence

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How to fill out request for escaping violence

01
Start by clearly stating your intention to escape violence and seek help.
02
Provide your personal information such as your full name, date of birth, and contact details.
03
Explain the nature of the violence you are experiencing, including any specific incidents or threats received.
04
Mention if you have any dependents or vulnerable family members who are also at risk.
05
Include any evidence or documentation you have related to the violence, such as police reports or medical records.
06
State your reasons for seeking escape, including the impact of the violence on your physical and emotional well-being.
07
Clearly outline the assistance or protection you are seeking, whether it is temporary shelter, legal support, or counseling.
08
If applicable, mention if you have any concerns about potential repercussions or retaliation for escaping.
09
Sign and date the request, expressing your readiness to cooperate with authorities or organizations in resolving the situation.
10
Keep a copy of the request for your records and share it with trusted individuals who can support you during the process.

Who needs request for escaping violence?

01
Anyone who is experiencing violence or abuse in any form. This could be individuals who are facing domestic violence, dating violence, sexual assault, stalking, human trafficking, or any other form of violence that poses a threat to their safety and well-being.
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A request for escaping violence is a form or application submitted by individuals who are seeking assistance to leave a dangerous or abusive situation.
Any individual who is experiencing violence or abuse and is seeking help to escape the situation is required to file a request for escaping violence.
To fill out a request for escaping violence, individuals can contact local law enforcement, domestic violence shelters, or social services agencies for assistance in completing the form.
The purpose of a request for escaping violence is to provide individuals with the necessary support and resources to safely leave a violent or abusive situation.
Information required on a request for escaping violence may include details about the abusive situation, contact information, safety concerns, and any additional support needed.
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