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WomanSafeHealth Trillium

Please complete the form on this page to receive advocacy services.

      Medical Advocacy

  • Insurance claims reimbursement  and navigating and benefits

  • Attending doctor’s appointments

  • Attaining and scheduling referrals

  • Researching diagnoses and procedures

  • Medical errands: calling in, dropping off and delivering medical prescriptions

  • medical samples/tests

  • Finding resources for medical, mental health, dental, etc. needs

  • Recovery strategizing

      Non Medical Advocacy

  • Assisting in home support

  • Household organization,

  • Academic facilitation

  • Goal setting and execution

  • Friend of the court (FOC) services/mediation

  • Reentering the workforce

  • Internet education

  • Preparing resume/CV

  • Applying for social services: insurance, child care, job placement,​ food assistance

 

I understand:

  • Woman advocacy promotes personal empowerment and care analysis to improve my wellbeing. My advocate's goal is to support me in improving my

     empowerment and skill sets related to the advocacy services I have requested.

  • My advocate is not an expert in any specific service beyond advocacy. My   

     advocate's scope of knowledge may be discussed, and my advocate is not 

     responsible for my overall outcomes.

  • Once I've submitted my request, all correspondence and documentation is billed at $55.00 per hour.

  • I am responsible for my own transportation.

  • At the end of my scheduled time, my advocate will have to leave.

  • The cost of woman advocacy is $55.00 per hour. My advocate's billable hours will include driving time, mileage/parking costs and post appointment      documentation.

  • If I miss an appointment or cancel with less than 24 hours notice, I will be   charged the full $55 per hour fee for the maximum time requested.

  • I need to pre-pay a non-refundable deposit for 30 minutes of my advocate's time to initiate my request. If the funds are not used within 30 days, I will need to make new request and make a subsequent payment.

  • A one time fee of $55 is incurred in the event that services are requested/filled in less than 1 business day or after 6 p.m.

By filling out the form below electronically, I agree to the above terms.

Upload File
Upload File

Click here to prepay and secure your woman advocacy services.

Advocacy Pledge

I pledge to welcome you, listen to you, believe you, protect your privacy, be accountable to you

and respect your “no.”
 

I pledge to be compassionate and professional. I pledge that I will have a high awareness, acceptance and affirmation of the specific needs you have as my client based on your age, gender, class, ethnicity, race and trauma herstory.
 

I am committed to engaging in open, honest and transparent communication with you

throughout this process.
 

It is my goal as your Woman Advocate to assist you in creating individualized goals and an individual definition of healing and wellness, including what it means to cope, manage and thrive.

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