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This application takes 20-40 minutes to complete. As part of the application process, we will be asking personal questions that may include details about your experience with trafficking, your personal history, and medical and legal matters. Your responses are important in helping us understand your situation and provide the best possible support and resources. Please be assured that all information you share will be kept confidential and used solely to assist your care and recovery. Please ensure you have the following information before you begin, as progress cannot be saved: Commercial Sexual Exploitation & Trafficking History; Family Summary; Addiction History; Abuse History; Health History; Arrest History; Education and Work History

**This application will be forwarded to our Intensive Outpatient team.
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COMMERCIAL SEXUAL EXPLOITATION & TRAFFICKING (CSET)

What is CSET? Commercial Sexual Exploitation: Any sexual activity that is traded or exchanged for something of value (or the promise of something of value), often for the purpose of survival. Sexual activity also includes pornography, stripping, exotic dancing, escorting, erotic massage, and street exploitation. Something of value includes but is not limited to, money, a place to stay, food, clothes, rent, transportation, drugs, medication, or survival. Trafficking: any commercial sexual activity where there is a third-party exploiter ("Daddy", partner, boyfriend, trafficker, manager, facilitator, family member) that aids in the commercial sexual exploitation of an individual.

SATANIC RITUAL ABUSE (SRA)

SRA refers to allegations of systematic and ritualistic abuse that purportedly involves the worship of Satan or other dark forces. Survivors may describe a range of experiences, including physical, sexual, and psychological abuse, as well as participation in rituals with occult themes.

FAMILY SUMMARY

ADDICTION HISTORY

ABUSE HISTORY & RELATIONSHIP STATUS

HEALTH HISTORY

LEGAL HISTORY

MOBILITY

EDUCATION & WORK HISTORY