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Crisis Services Contact Form 
Please use this form to submit any inquiries or feedback to the Crisis Services team. Your submission will be used to provide feedback to our Crisis Services team to improve the quality of our service. We may also use your feedback, in a de-identified manner, for training, research, development/fundraising, and promotional purposes. This form should not be used for the purposes of counseling, support, or emergency services. If you wish to speak to a Crisis Counselor, visit our Get Help page (https://www.thetrevorproject.org/get-help/). 
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  • English (US)
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    Please select 1.
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    Please select 1.
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  • 5
    If exact day is unknown, please select an approximate day of service. If a date of service is not applicable, leave blank.
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    NOT VISIBILE ON FORM
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