ISVA Self Referral

Use this form to refer yourself to the ISVA Service if you are aged over 14. This page also provides guidance to help you complete the form.

Guidance for self-referring

This is not exhaustive but is intended as a general guide to help you before you give us any personal information.

The role of the ISVAtoggle accordion content

The ISVAs at Survivors’ Network are specially-trained workers who can provide practical information and support to anyone 14 or over who has experienced recent or non-recent sexual violence or abuse. We cover Brighton & Hove and East Sussex. (If your referral is for someone aged under 14, please use this form instead.)

The focus of our work largely centres around the criminal justice process, which can include: explaining what your options may be in terms of making a report, facilitating initial contact with the police, passing on anonymous information from you to the police about a sexual crime that has taken place, providing police liaison throughout an investigation if you have made a report, information and support in the lead up to a trial, attending a visit to a court room to look around in advance of a trial and offering support at court.

Because sexual violence and abuse can have wide-ranging and profound impacts on a person’s life, we will also work with you to create a plan of support to consider the ways in which you have been affected by what has happened, outside of the criminal justice process. This may involve referring on/signposting to other specialist agencies, such as housing teams.

Confidentialitytoggle accordion content

We have a comprehensive confidentiality statement that will be explained to you when we make contact. However, before passing over any information to us, we feel it is important that you are aware that under certain circumstances we may have a duty to share information with the relevant agencies (such as the police or social services). Situations where this may occur are:

  • Where there are concerns about a child or vulnerable adult’s safety.
  • If we know of information that gives us concerns that you or another person may be at risk of serious harm.
  • If we are ordered by a court of Law to breach confidentiality
  • If we gain knowledge regarding certain crimes, such as a possible terrorist threat or drug dealing activity.

Should it be necessary to breach confidentiality, we will attempt to discuss our concerns with you first, and we will try to involve you as much as possible. If you have any concerns about this, you can call us to chat about this before submitting a referral form.

Information we needtoggle accordion content

We ask for certain information on the form, including a bit about the sexual violence and/or abuse you have experienced. Please only give information that you feel comfortable sharing at this stage. It can help us feel better equipped to best support you if we know roughly what may have happened, how long ago, and who the perpetrator(s) was, but do appreciate this can be difficult information to disclose, so do not feel you have to go into great detail.

If you are able to give us anything else that may help us support you better, such as an idea of what it is you would like from the service, any particular needs you may have and safe contact details, then there is space for all of this on the form.

What you can expect after making a referraltoggle accordion content

We will attempt to make contact via the details given within a week of us receiving a referral. We will only leave messages, email or post if we know it is safe to do so. Upon contacting you, we will complete an ‘Initial assessment’ with you, to gain more of a sense about what is going on for you and how we may be able to support you and then discuss how your case will be managed from there.

If you prefer you can download the form as a Word document to fill out in your own time, you can post the form to us or drop it into our office – see our contact page for details.

You can also email a completed form to referrals@survivorsnetwork.org.uk, or if you are a professional emailing from a secure account you can send it to isva.referrals@survivorsnetwork.cjsm.net