Eva Program Application for Services
The Eva Foundation has merged with Victims for Justice and will be continuing to provide services as the Eva Program.
(criminal record and history of substance abuse do not automatically disqualify you from receiving services)
Application must be completed in full to be processed.
ATTENTION REFERRING AGENCY: It is important that the referring agency support the client in filling out this application. If you are not familiar with the client’s history please have the client submit this application through an agency/advocate that is better able to support them in this process.
Statement of Understanding
When you are a recipient of Eva Program services or an agency representing a referral, please be advised of the
The Eva Program provides services to survivors of abuse ONLY. If your client has been found/plead guilty to assault or any other type of abuse he/she does not quality for our services. We do not provide direct services. We provide items, gift cards, and/or refer clients to service providers based on individual needs. Please note: Form must be signed by applicant. Not every service will be provided for every client. Please, allow 2 weeks for complete processing.
We strive to meet the needs of all referrals in as timely a manner as possible. The Program will process the application within two weeks of the submission date. All contact information must be completed on the application. Until the information is completed and received either directly from the applicant or the referring agency, the application will not be
Communication is important in helping all referrals who apply to the Eva Program. The Eva Program Director will follow up with the agency or referral directly as needed, on a case by case basis.
Partnerships, such as dental, optical, and veterinarian service providers in the community who support the Eva Program reserve the right to revoke professional services if an appointment is made and the referral is a ‘no show’. Out of respect for our partners, if you need to cancel or change an appointment, please note that 24-48 hour notice is required. If this guideline is not met, the provider of that service is not obligated to reschedule.
The Eva Program is not responsible for services provided by Eva Program Partners nor does a partner referral constitute an endorsement. It is the understanding of the signee that all service issues resulting from a partner referral must be resolved by the signee and the business partner.
If you receive a gift card for professional grooming, or any other service, please call first to make an appointment. Many businesses do not have openings for walk in appointments. Quality of service is important to the Program, please be respectful of the businesses that are providing the services. If you need to cancel or change an appointment, please note that 24-48 hour notice is required. If this guideline is not met, the provider of that service is not obligated to reschedule.
Please note all referrals are responsible for providing truthful history to the agency that is referring them or directly to the Program. If any referral is not being honest about their history, the referral will be terminated from the program. The mission of the Program is to help survivors of abuse regain their self-confidence and independence to build a better life. The Program reserves the right to refuse services to anyone. By submitting this application, I the client understand the policies of the Eva Program, and will adhere to all guidelines noted
Lexi Rickard, Eva Program Director