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Let us safely contact you

We are here to support you if you are experiencing any form of financial, economic, or domestic abuse. Use our form to let us know when you want us to contact you.

Things to think about

  • We will only use the information you give us so we can contact you. This information will be deleted after.
  • We will only attempt to call you once. If you are unable to answer, but you still want to speak to us, please complete the form again.
  • Visiting this page may show in your internet browser history. You might need to remove your browser history afterwards, or use a secure device that your abuser does not have access to.
  • We consider the information you provide on the form to be confidential. The same is true for the conversation our trusted team goes on to have with you.
  • If you're in immediate danger, please call the police on 999. If you cannot speak when the operator answers, press 55 to let them know you are in danger. You can also call the National Domestic Abuse Helpline on 0808 2000 247. Refuge run this free service. It is available 24 hours a day, seven days a week.

Personal details

Select Title

Enter First name

Enter Last name

We will only try and call you on this number.

Enter Telephone number

Postcode is a required field.

Best times to call you

Choose up to three dates and times you are available. We can call you between 9am to 5pm, Monday - Friday. Please give at least 24 working hours' notice from the time you submit the form.

Option 1

Enter date

We will only try to contact you during this time.

Enter Time

Option 2

Enter date

We will only try to contact you during this time.

Enter Time

Option 3

Enter date

We will only try to contact you during this time.

Enter Time

Is there anything you'd like us to know before we call? If not, leave blank.

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