LAHRI/SCHRC Centralized Referral Form

  • Direct Referral Case Submission

    Cases with an affidavit deadline of less than 4 weeks can be very difficult to place. Please try to submit cases with a deadline as far in advance as possible. If your client is currently in detention, please give us at least 6-8 weeks to schedule the case. We will always make every effort to ensure all clients have the opportunity for a forensic examination. ***ATTENTION ATTORNEYS: please save contact@lahumanrights.org & contact@southerncaliforniahumanrightscenter.com in your email as soon as possible, so our email to you does not go into spam.

  • Attorney Information

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  • Client Information

  • Type of evaluation(s) requested*
  • Can the examination be performed virtually (e.g., over Zoom), or will the evaluation require in-person examination?*
  • Our clinics require that you provide an interpreter if needed. Do you agree to this?*

  • Case Details

  • Grounds for asylum claim*
  • Date of hearing
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  • Deadline for final affidavit*
     - -
  • Which clinic(s) would you prefer? We cannot guarantee your preferences. No preference is an option.*

  • Has your client consented to an evaluation by a PHR/LAHRI/KHRC member?

    By consenting to an evaluation, your client grants PHR/LAHRI/KHRC permission to use information gained from the evaluation in its advocacy efforts to fight persecution around the world. All information will be de-identified and data aggregated for inclusion in PHR/LAHRI/KHRC reports and materials. PHR/LAHRI/KHRC will never disclose your client’s name, A-number, or any other identifying information without his or her express written permission. Email contact@lahumanrights.org with any questions.

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