• Welcome to SASC's Online Intake Services

  • Thank you for your interest in our Family Court Support Program. Please take the time to fill out our online intake to the best of your abilities, it should take about 10 minutes to complete. If you have any questions or would like to complete your intake in person, please reach out to our office at 519-571-0121 x 108 or email courtsupport@sascwr.org.

    The purpose of this form is to streamlineyour intakeprocess. If you are not comfortable answering any of these questions, please feel free to skip to the next question.To continue onto our Family Court Support Program Referral and Intake Form, please click "Next."

  • Referral and Intake Form

    Personal Information
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    Pick a Date

  • Contact Information

    Please note that at least one means of communication must be filled. We strongly encourage you to provide an email address.

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  • Referral and Intake Form

    Legal Information

  • The purpose of the needs assessment is for the Family Court Support Worker to evaluate and document your needs as well as any supports and resources for which you may be eligible for.

  • Ex Partner Information:


  • Children:

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  • Involvement With Legal System:




  • Sexual Assault Support Centre of Waterloo Region

    Family Court Support Program - Intake and Referral Form

  • Abilities and Limitations of the Family Court Support Program

    The Family Court Support Worker's role is to:

    • Provide support to clients who have experienced any form of domestic violence and who are involved in or are beginning, the family court process.
    • Provide information about the family court process.
    • Assist clients through the legal aid process.
    • Assist in documenting the history of abuse for court documents.
    • Enhance safety through safety planning, especially related to court attendance.
    • Provide appropriate referrals and resources based on individual client needs.
    • Support clients to follow through on requests received from their lawyer.
    • Debrief and discuss court outcomes, lawyer appointments, Family Law Information centre meetings, consultations with duty counsel, and/or next steps.
    • Provide, where appropriate, accompaniments to court proceedings and lawyers appointments. This needs to be arranged in advance with the Family Court Support Worker. Accompaniments at times may be provided through a team of trained and supervised family court volunteers.
    • If applicable, will provide support before, during and after any Criminal Injuries Compensation Board (CICB) processes.

    The Family Court Support Worker CANNOT:

    • Provide legal advice. Please speak with a lawyer or duty counsel.
    • Make legal decisions on behalf of the client. We can help you explore your options, but all decisions are up to you.
    • Speak on behalf of clients. We can support you in clarifying what you would like to address with your lawyer or duty counsel; however, we will not say these words for you.
    • Provide support to friends and/or family members that may attend court proceedings with the client. Our role is to support you during that time.
    • Approach clients outside of family court. We are open to you approaching us in public, but we will never initiate contact in order to maintain your confidentiality.

  • Please Note:

    It is our policy that to access services, both the client and the worker must consent to working together within terms outlined. You are welcome to engage in further discussion with your worker during your first appointment if you have further questions or concerns.

  • Client Confidentiality Agreement

  • I understand that all services are confidential within the agency and that the release of any information outside of the Sexual Assault Support Centre of Waterloo Region (SASC) regarding my involvement may occur only upon my written consent. I also understand that the exceptions to this include:

    • Suspected child abuse or neglect. SASC staff and volunteers are required by law to inform Family and Children Services (F&CS) of any suspected child at risk. This includes a child that has witnessed a parent or caregiver being harmed.
    • When a client indicates that she is a danger to herself or others
    • In cases of court orders and/or search warrants

    In addition, I agree to maintain confidentiality of any client or volunteer that I may encounter at SASC, including not disclosing that I have seen them.

  • Please Note:

    It is our policy that to access services, both the client and the worker must consent to working together within terms outlined. You are welcome to engage in further discussion with your worker during your first appointment if you have further questions or concerns.
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