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Are you referring yourself or are you an organisation referring an individual to us?

Organisation details

Do you have permission from the person being referred to contact us? *Forth Valley Rape Crisis will never contact a survivor who has not given their consent to have their details passed on to us.

Personal Details

If we are unable to get you on the telephone number you provided can we send a letter to this address?
Do you need an interpreter?
Are you D/deaf or hard of hearing?
Is it safe for us to say we are calling from Rape Crisis when we call you?
Can we send a text to this number?
Can we leave a voicemail on this number?


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FVRCC’s legal basis for processing and storing your information under the General Data Protection Regulation (GDPR) is consent. This means that you have real choice and control over how we manage and use your data. You can withdraw your consent at any time. By ticking this box you consent to FVRCC holding the information you have provided us with on our secure database