Request an Appointment

Thank you for reaching out to Cleveland Rape Crisis Center.

Please fill out the following form to request an appointment for victim assistance, counseling and other programs at any of our locations in Cuyahoga County, Lake County, Geauga County or Ashtabula County.

We will contact you within 1-2 business days to connect you with our services and answer any questions you may have.

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Request an appointment
Please be advised that due to HIPAA and confidentiality laws we cannot contact adults without their consent. If you are a parent, teacher or other caring adult for a survivor over 18, only fill out this form with their knowledge and full agreement. Thank you!